摘要
目的制定自发性脑室内出血的最佳治疗方案,最大限度的降低死亡率及致残率。方法对243例自发性脑室内出血病人的内科治疗、脑室引流术和开颅血肿清除术3种不同方法进行对比研究。结果内科治疗、脑室引流术和开颅血肿清除术3组死亡率之间无显著差异(P>0.05),但Ⅰ级病人3种不同治疗方法的死亡率以内科治疗最低(0%),Ⅱ级3种不同治疗方法的死亡率无显著差异(P>0.05),Ⅲ级病人以开颅血肿清除术死亡率最低(72.2％),Ⅳ级病人3种治疗方法死亡率均为100％;3种治疗方法中脑室引流治愈率最高(68%);Ⅱ级病人中,超早期、早期及延期手术死亡率之间差异显著(P<0.05);超早期手术的高功能恢复率最高(93.9％)。结论自发性脑室内出血的最佳治疗方案为:Ⅰ级病人内科治疗,Ⅱ级病人首选超早期脑室引流术,Ⅲ级病人行超早期开颅血肿清除术,Ⅳ病人除探索新治疗方法外,可试行超早期手术。
Objective To make an optimal treatment project of spontaneous intraventricular hemorrhage so as to reduce its mortality and morbility to the greatest extent. Methods Three therapies (medical conservative treatment, ventricular drainage and craniotomy plus evacuation of intracerebral and intraventricular hematomas) were comparatively studied in 243 cases with spontaneous intraventriculair hemorrhage. Results The difference of mortalities among medical conservative treatment, ventricular drainage and craniotomy plus evacuation of intracerebral and intraventricular hematomas was not significant statistically (P> 0.05) . But the mortality of medical conservative treatment was the lowest (0%) among the three therapies in Grade Ⅰ patients. There was no statistical difference among the three therapies in Grade Ⅱ patients (P> 0.05) . The mortality of craniotomy plus evacuation of intracerebral and intraventricular hematomas was the lowest (72.2%) among the three therapies in Grade Ⅲ patients and the mortality of the three therapies were all 100% in Grade Ⅳ patients. The healing rate of ventricular drainage was the highest (68%) among the three therapies. The difference of mortalities of the ultra - early, early and delayed operation was significant statistically (P < 0.05) in Grade Ⅱ patients. The high neurological functional recovering rate of ultraearly operation was the highest (93.9%) . Conclusion The optimal treatment project of spontaneous intraventricular hemorrhage was as follows: medical conservative treatment for Grade Ⅰ, ultra - early ventricular drainage for Grade Ⅱ , ultra - early craniotomy plus evacuation of intracerebral and intraventricular hematomas for Grade Ⅲ and ultra - early operation for Grade Ⅳ in addition to actively exploring new therapy.
出处
《医学研究通讯》
2002年第7期7-11,共5页
Bulletin of Medical Research
