双侧侧脑室外引流联合尿激酶冲洗治疗脑室内出血疗效分析

目的探索双侧侧脑室外引流联合尿激酶冲洗治疗脑室内出血的临床疗效。方法将2006年2月至2013年8月襄阳市中心医院神经外科收治的120例脑室内出血患者依据治疗方法不同分为对照组和治疗组各60例,对照组采用单侧侧脑室外引流治疗,治疗组采用双侧侧脑室外引流加尿激酶溶液冲洗治疗,对比两组患者的临床疗效。结果治疗组病死率显著低于对照组(13.3%vs 28.3%),差异有统计学意义(χ2=4.093,P=0.043);治疗组总有效率高于对照组(75.0%vs 53.3%),差异有统计学意义(χ2=6.125,P=0.013)。对照组存活的43例患者中脑室内出血消散时间≤7 d占51.2%(22/43),治疗组存活的52例患者中脑室内出血消散时间≤7 d占71.2%(37/52),差异有统计学意义(P<0.05)。两组迟发型脑水肿发生率比较差异有统计学意义(P<0.05)。结论双侧侧脑室外引流联合尿激酶冲洗治疗脑室内出血疗效好,且并发症较少,应在临床推广使用。

Therapeutic Analysis of Bilateral Lateral Ventricle Drainage Combined with Urokinase Flush Treatmeng of Intraventricular Hemorrhage

Objective To explore the clinical efficacy of bilateral lateral ventricle drainage combined with urokinase flush treating intraventricular hemorrhage. Methods From Feb. 2006 to Aug. 2013 in Xiangyang City Central Hospital 120 cases of intraventricular hemorrhage were included in the study and divided into control and treatment group（ n = 60 ） according to random number table method：the control group received unilateral drainage treatment of lateral ventricle ,the treatment group was treated with bilateral lateral drainage combined with urokinase flush, and the clinical efficacy of the two groups was compared. Results Mortality rate of the treatment group was significantly lower than the control group （ 13.3% vs 28.3% ） with statistically significant difference（ x^2 = 4. 093, P = 0. 043 ） ; the total effective rateof the treatment group was significantly higher than the control group（75.0% vs 53.3% ） with statistically significant difference（ x^2 = 6. 125, P = 0. 013 ） ; among the 43 survivors in the control group, the cases of intraventricular hemorrhage dissipation time ≤ 7 d accounted for 51.2 % （22/43）, while among the 52 survivors in the treatment group, the cases of intraventricular hemorrhage dissipation time ≤ 7 d accounted for 71,2% （ 37/52）, the difference was statistically significant （ P 〈 0.05 ） ; late-onset incidence of cerebral edema of the two groups had statistically significant differences （ P 〈 0.05 ）. Conclusion Bilateral ventricle drainage combined with urokinase flush treatment of intraventricular hmorrhage has better efficacy and fewer complications, which should be promoted in clinical.