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目的为了治疗和预防脑室内出血后脑积水的发生和发展，改善新生儿严重脑室内出血的不良预后。方法1989年以来，对19例在出生后早期经头颅B超诊断为严重脑室内出血（IVH）患儿进行了连续腰穿（LP）治疗。结果有效16例，自动出院1例，失败2例。有效率为84．2％。有效16例初次LP日龄为14．6±5．7d，疗程23．4±12d，平均LP次数9．3±4．7次，平均LP间隔期3．1±1．6d，平均每次放液量6．7±2ml，LP治疗后起效天数为10．1±7．8d。2例在连续LP的同时联用乙酰唑胺治疗亦取得显著疗效。16例平均随访月龄为3．2±1月，体格发育均正常，B超显示12例脑室形态正常，4例脑室呈稳定的轻度增大。失败的2例初次LP迟，初期LP间隔期延长为7－9d，放液量＜5ml。同期另有17例严重IVH患儿未予LP治疗。其中4例并发脑积水，5例自动出院，4例早期死亡，余4例其后脑室形态稳定。结论连续LP不失为治疗新生儿严重IVH实用安全有效的方法，LP疗效欠佳时可联用乙酰唑胺治疗。
Objective To treat and prevent the occurrence and development of hydrocephalus after intracerebral hemorrhage and to improve the adverse prognosis of neonatal severe intraventricular hemorrhage. METHODS: A total of 19 children with severe intraventricular hemorrhage (IVH) who underwent early cranial B-ultrasound diagnostics for consecutive lumbar puncture (LP) have been treated since 1989. 16 cases were effective, 1 case was discharged automatically and 2 cases failed. The effective rate is 84.2%. Effective 16 cases of primary LP age was 14.6 ± 5.7d, course of treatment was 23.4 ± 12d, the average number of LP 9.3 ± 4.7 times, the average interval of LP 3.1 ± 1.6d, on average each time 6.7 ± 2ml liquid release, LP treatment after the onset of the number of 10.1 ± 7.8d. 2 cases in the continuous LP with acetazolamide treatment also achieved significant effect. The mean follow-up age of 16 cases was 3.2 ± 1 months, with normal physical development. B-mode ultrasound showed normal ventricular morphology in 12 cases and mild stable increase in 4 cases. Two cases of failed initial LP late, the initial LP interval extended to 7-9d, liquid volume <5ml. In the same period, another 17 patients with severe IVH were not treated with LP. 4 cases were complicated by hydrocephalus, 5 cases were discharged automatically, 4 cases died early, and the other 4 cases had stable ventricular morphology. Conclusion Continuous LP is a safe and effective method for the treatment of severe IVH in neonates. When LP is not effective, acetazolamide may be used in combination.