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目的:探讨超声波引导侧脑室刺穿引流治疗早产儿颅内出血后脑积水(PHH)的效果。方法:选取我院2012年5月至2014年6月收治的5例PHH早产儿,采用超声波引导侧脑室刺穿引流进行治疗,回顾性总结分析其治疗过程和临床特点。结果:5例患儿均成功进行穿刺引流,其中单侧引流4例,双侧引流1例,引流时间4~9 d,引流量5~55 m L/d。4例治疗有效,1例治疗无效后死亡,有效率80%。2例治疗过程中出现发热,经静脉给予抗生素治疗,2 d后发热症状好转并逐渐消失。治疗至引流液中WBC、RBC、PTA等生化指标正常时可考虑拔出引流管。结论:超声波引导侧脑室刺穿引流治疗早产儿PHH,具有穿刺次数少、放液量多、引流路径短等特点,有一定的临床应用价值。
Objective: To investigate the effect of ultrasound-guided lateral ventricle puncture and drainage on hydrocephalus (PHH) after intracranial hemorrhage in premature infants. Methods: Five PHH preterm infants admitted to our hospital from May 2012 to June 2014 were selected and treated with ultrasound guided lateral ventricle puncture and drainage. The treatment course and clinical features were retrospectively analyzed. Results: Puncture and drainage were successfully performed in all 5 cases. Among them, unilateral drainage in 4 cases, bilateral drainage in 1 case, drainage time in 4 ~ 9 days and drainage in 5 ~ 55 m L / d. 4 cases of effective treatment, 1 case died after treatment ineffective, the effective rate of 80%. Two cases of fever occurred during the treatment, intravenous antibiotics, 2 d fever symptoms improved and gradually disappear. Treatment to the drainage fluid WBC, RBC, PTA and other biochemical indicators may be normal drainage pull out. Conclusion: Ultrasound-guided lateral ventricle puncture and drainage for the treatment of PHH in preterm infants has the characteristics of less puncture, more fluid and shorter drainage pathways, which has certain clinical value.