Objective To observe the therapeutic effect of intraventricular puncture and purification of cerebrrospinal fluid with spinal puncture for treatment of intraventricular hemorrhage casting. Methods Thirty-four cases of intraventricular hemorrhage casting received continuous drainage and urokinase lavage, plus intraventricular puncture and purification of cerebrrospinal fluid with spinal puncture. Meanwhile, 30 cases, as the control group,had routine conservative therapy, Results Ventricle patency time, cerebrospinal fluid normalization time,consciousness recovery time and hospitalization in the therapy group were significantly shorter than the control group.Re-bleeding rate in the therapy group showed no difference from control group. Mortality, morbidity and late hydrocephalus in the therapy group were significantly lower than the control group. Curative rate in the therapy group was significantly higher than the control group. Conclusion Intraventricular puncture and purification of cerebrrospinal fluid with spinal puncture proved to be an effective method for treating intraventricular hemorrhage casting.%目的 探讨脑室穿刺加腰椎穿刺脑脊液置换治疗脑室出血铸型的疗效.方法 在双侧侧脑室前角穿刺持续外引流及尿激酶灌注的基础上,进行腰椎穿刺脑脊液置换术并注入尿激酶治疗脑室出血铸型34例(治疗组),与内科常规治疗30例(对照组)进行对照分析.结果 治疗组脑室通畅时间、脑脊液正常时间、神志转清时间、住院天数均较对照组明显缩短(P<0.01),再出血发生率(8.82%)较对照组(10.00%)无统计学意义(P>0.05),病死率(20.60%)较对照组(80.00%)显著下降(P<0.01),治愈率(44.10%)较对照组(6.70%)显著提高(P<0.01),存活病例致残率(44.40%)较对照组(66.70%)低(P<0.05),迟发性脑积水(7.40%)较对照组(33.30%)显著下降(P<0.01).结论 在双侧侧脑室前角穿刺持续外引流及尿激酶灌注的基础上,进行腰椎穿刺脑脊液置换术并注入尿激酶,是救治脑室出血铸型患者的一种积极、有效、简便的方法.
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