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继发性脑室内出血可是高血压性脑出血的一种严重类型,此时采用脑室持续外引流血性脑脊液是重要的治疗手段。我科自1990年1月至1995年2月采用此法治疗56例,疗效良好,现报道如下。 临床资料 1.一般资料:男37例,女19例。年龄38～74岁,平均56岁。入院时血压16～27/10～14kPa。临床表现为头痛、呕吐9例,神志朦胧15例,浅昏迷14例,中度昏迷11例,深昏迷7例;一侧瞳孔散大8例,双侧瞳孔散大4例;去脑强直4例,单或双侧病理征阳性28例。入院时格拉斯哥昏迷计分(GCS):3～5分12例,6～8分27例,9～12分17例。 2.CT检查结果:病人均经头颅CT检查确诊。(1)出血部位:壳核出血18例,丘脑出血23例,两者混合10例,小脑出血5例。(2)出血破入脑室部位:出血破入一侧脑室19例,双侧脑室14例,侧脑室及第三脑室8例,第四脑室6例,全脑室积血9例。(3)根据多田明等提出的血肿量计算公式计算脑室内积血量。少量积血(<20ml)26例,中量积血(20～30ml)13例,大量积血(>30ml)17例。
Secondary intraventricular hemorrhage, but a serious type of hypertensive intracerebral hemorrhage, the use of intraventricular continuous outflow of bloody cerebrospinal fluid is an important treatment. Our department from January 1990 to February 1995 56 cases of this treatment, good effect, are reported below. Clinical data 1. General information: 37 males and 19 females. Age 38 ~ 74 years old, average 56 years old. Admission of blood pressure 16 ~ 27/10 ~ 14kPa. Clinical manifestations of headache, vomiting in 9 cases, 15 cases of vague consciousness, coma in 14 cases, 11 cases of moderate coma, dark coma in 7 cases; one side mydriasis in 8 cases, bilateral mydriasis in 4 cases; Cases, single or bilateral pathological signs of positive in 28 cases. On admission, Glasgow coma score (GCS): 3 to 5 in 12, 6 to 8 in 27, and 9 to 12 in 17. 2.CT test results: patients were diagnosed by head CT examination. (1) bleeding site: 18 cases of hemorrhage in the putamen, 23 cases of thalamic hemorrhage, both mixed in 10 cases, 5 cases of cerebellar hemorrhage. (2) bleeding into the ventricle site: hemorrhage broke into one side of the ventricle in 19 cases, 14 cases of bilateral ventricle, lateral ventricle and third ventricle in 8 cases, fourth ventricle in 6 cases, 9 cases of whole ventricular hemorrhage. (3) Calculate the amount of intracerebral hemorrhage according to the calculation formula of hematoma volume proposed by Toda Tian et al. There were 26 cases with small amount of hemorrhage (<20ml), 13 cases with moderate hemorrhage (20 ~ 30ml) and 17 cases with massive hemorrhage (> 30ml).