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目的探讨双侧侧脑室外引流及腰穿逆行冲洗治疗高血压性全脑室铸型出血的疗效。方法将2005年1月至2010年6月收治的20例高血压性全脑室铸型出血患者随机分成2组:实验组10例行双侧侧脑室外引流加腰穿逆行冲洗,对照组10例单行双侧侧脑室外引流。观察脑室内血肿清除时间并评定治疗效果。结果实验组脑室内血肿清除时间明显少于对照组〔(5.20±2.16)dvs(7.80±2.22)d,P<0.05〕。治疗4周后按《脑卒中临床神经功能缺损程度评分标准》进行评分,实验组评分明显少于对照组〔(21.60±12.18)vs(32.20±10.42)分,P<0.05〕。实验组恢复良好3例,中度残疾2例,重度残疾3例,植物状态1例,死亡1例;对照组恢复良好1例,中度残疾2例,重度残疾2例,植物状态3例,死亡2例。结论双侧侧脑室外引流联合腰穿逆行冲洗,能显著改善高血压性全脑室铸型出血患者的预后,是治疗高血压性全脑室铸型出血行之有效的方法。
Objective To investigate the curative effect of bilateral lateral ventricle drainage and lumbar puncture retrograde flushing on hypertensive whole ventricular casts. Methods Twenty patients with hypertensive whole ventricular hemorrhage from January 2005 to June 2010 were randomly divided into two groups: 10 in the experimental group underwent bilateral lateral ventricle drainage plus lumbar puncture and retrograde flushing, and 10 in the control group Single lateral bilateral ventricle drainage. Observation of intraventricular hematoma removal time and evaluate the therapeutic effect. Results The clearance time of intraventricular hematoma in experimental group was significantly less than that in control group [(5.20 ± 2.16) d vs (7.80 ± 2.22) d, P <0.05). The score of experimental group was significantly lower than that of the control group [(21.60 ± 12.18) vs (32.20 ± 10.42) points, P <0.05〕 after 4 weeks of treatment according to the standard score of clinical neurological deficit in stroke. The experimental group recovered well in 3 cases, moderate disability in 2 cases, severe disability in 3 cases, plant state in 1 case and death in 1 case. The control group recovered well in 1 case, moderate disability in 2 cases, severe disability in 2 cases, plant state in 3 cases, 2 died. Conclusion Bilateral lateral ventricle drainage combined with lumbar puncture retrograde flushing can significantly improve the prognosis of patients with hypertensive whole ventricular cast hemorrhage and is an effective method for the treatment of hypertensive whole ventricular cast hemorrhage.