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丘脑出血破入脑室后对内囊传导束压迫相对减轻,但致脑室内积血而阻碍了脑脊液(CSF)循环,出现持续性头痛,加重了意识障碍。本文系1995年1月至1998年1月收治住院患者采用多次放血性CSF并鞘内注射地塞米松(25例)后,在患者意识障碍好转天数、头痛缓解天数、住院天数与对照组(23例)比较,均有显著性差异。现报道如下。 1 资料来源 1.1 一般资料 男30例,女18例,年龄45～75岁,平均(61.3±13.8)岁,发病后6～78小时就诊,平均就诊时间(16.8±14.6)小时,高血压病史14例,糖尿病(Ⅱ)史3例。 1.2 临床资料 头痛46例,呕吐30例,抽搐7例,谵妄9例,眼球凝视5例,嗜睡35例,浅昏迷4例。头颅CT证实丘脑出血破入脑室,其中左侧29例,右侧21例。全部病例入院后4～12小时做腰穿(LP),平均腰穿时间(6.5±4.1)小时,腰穿出均一血性CSF 45例或黄色CSF 3例,测脑脊液压力200～400mmH_2O,平均(290.4±88.6)mmH_2O,其中>300mmH_2O占35例。入院后头颅CT排除原发性蛛网膜下腔出血(SAH)及原发性脑室出血(PIVH),随机分为二组,25例为治疗组,23例为对照组。
Thalamic hemorrhage ruptured into the ventricle relative to the internal capsule conduction pressure reduction, but caused by intracerebral hemorrhage and hindered the cerebrospinal fluid (CSF) circulation, persistent headache, aggravated the disturbance of consciousness. This article is from January 1995 to January 1998 admitted to hospitalized patients with multiple hemorrhagic CSF and intrathecal dexamethasone (25 cases), the number of days in patients with disturbance of consciousness, the number of days of headache relief, hospitalization days and the control group ( 23 cases), there are significant differences. Report as follows now. 1 Source 1.1 General Information 30 males and 18 females, aged 45 to 75 years, mean (61.3 ± 13.8) years old, 6 to 78 hours after onset of treatment, the average treatment time (16.8 ± 14.6) hours, history of hypertension 14 Cases, diabetes (Ⅱ) history of 3 cases. 1.2 Clinical data Headache in 46 cases, 30 cases of vomiting, convulsions in 7 cases, delirium in 9 cases, 5 cases of staring eye, lethargy in 35 cases, 4 cases of coma. Head CT confirmed thalamic hemorrhage broken into the ventricle, of which 29 cases of left and right in 21 cases. All patients were given lumbar puncture (LP) 4 to 12 hours after admission. The mean lumbar puncture time was (6.5 ± 4.1) hours. Out of the 45 cases of homogenized hematologic CSF or 3 cases of yellow CSF, the mean CSF pressure was 200-400 mmH 2 O (average 290.4 ± 88.6) mmH_2O, of which> 300mmH_2O accounted for 35 cases. After admission, head CT exclusion of primary subarachnoid hemorrhage (SAH) and primary intraventricular hemorrhage (PIVH) were randomly divided into two groups, 25 patients in the treatment group and 23 patients in the control group.