高血压脑室内出血微创钻孔外引流术的临床研究

摘要

Objective To study the curative effect of minimally invasive drilling external drainage in the treatment of hypertensive intraventricular hemorrhage. Methods Selected 45 cases of hypertension patients with ventricular hemorrhage as the research object, all patients were performed minimally invasive drilling drainage and intraventricular infusion urokinase, observed treatment effect. Results All 45 patients were successfully completed surgery, surgery average (36.8±10.5) min, 2~4 d after surgery, there were 8 cases of death, the mortality rate was 17.8%, the rest 37 patients, treated with urokinase lavage after intraventricular hematoma disappeared, and no the phenomenon of expanding ventricle system. There were 7 cases of postoperative pulmonary infection, 15.6%(7/45), 3 cases with gastrointestinal bleeding, 6.7%(3/45). 45 cases of patients with minimally invasive drilling after external drainage, 75.6%(34/45) of patients daily life ability to restore good (grade I 18 cases, gradeⅡ12 cases , gradeⅢ 4 cases), 6.7%(3/45) of patients ADL ability restore daily life poorer levels (gradeⅣ2 cases, gradeⅤ1 case). Conclusion For patients with hypertensive intraventricular hemorrhage, early application of minimally invasive drilling in combination of drainage urokinase lavage, has significant therapeutic effect, and easy to operate, so it is worthy of popularization and application.%目的：探讨微创钻孔外引流术治疗高血压脑室内出血的临床疗效。方法选取45例高血压脑室出血患者作为研究对象,所有患者均行微创钻孔外引流术并脑室内灌注尿激酶,观察治疗效果。结果45例患者均顺利完成手术,手术平均用时(36.8±10.5)min。在术后2~4 d,共有8例死亡,死亡率为17.8%。其余37例患者,应用尿激酶灌洗后,脑室血肿消失,且脑室系统无扩大现象。术后有7例发生肺部感染,占15.6%(7/45),3例出现消化道出血,占6.7%(3/45)。45例患者行微创钻孔外引流术后,有75.6%(34/45)的患者日常生活能力恢复较好(Ⅰ级18例、Ⅱ级12例、Ⅲ级4例),有6.7%(3/45)的患者ADL日常生活能力恢复较差(Ⅳ级2例、Ⅴ级1例)。结论对于高血压脑室内出血患者,早期应用微创钻孔外引流术联合尿激酶灌洗,具有显著的治疗效果,且操作简便,值得推广应用。