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目的探讨脑出血破入脑室的治疗方法与效果。方法根据头颅CT影像学特征采用个体化治疗方案:(1)A组血肿以脑室系统为主,脑室外血肿量小于30ml者行双侧脑室外引流术;(2)B组血肿以脑室系统为主,脑室外血肿量大于30ml者行血肿清除术+对侧脑室外引流术;(3)C组血肿以脑实质内为主,为单侧脑室积血,第Ⅲ、Ⅳ脑室无铸造形,脑室外血肿量大于30ml者行血肿清除术。结果A组恢复良好率59.4%,不良率18.7%,病死率21.9%;B组恢复良好率58.4%,不良率20.8%,病死率20.8%;C组恢复良好率57.1%,不良率23.8%,病死率19.1%。结论对脑出血破入脑室者根据头颅CT影像学特征,并结合脑室内、外血肿情况综合分析,采用个体化治疗方案,可提高患者的生存质量和预后,减少并发症,降低致残率及病死率。
Objective To investigate the treatment and effect of cerebral hemorrhage penetrating the ventricle. Methods According to the characteristics of cranial CT imaging, individualized treatment was adopted: (1) In group A, the ventricular system was predominant in the hematoma and the extracerebral hematoma was less than 30ml. (2) The ventricular system in group B was The main and extracerebral hematoma volume greater than 30ml were hematoma removal + contralateral ventricle drainage; (3) C group of hematoma mainly in the brain parenchyma, unilateral ventricular hemorrhage, Ⅲ, Ⅳ ventricular non-casting shape, Extracerebral hematoma volume greater than 30ml were hematoma removal. Results In group A, the recovery rate was 59.4%, the non-performing rate was 18.7% and the mortality rate was 21.9%. In group B, the recovery rate was 58.4%, the non-performing rate was 20.8% and the mortality rate was 20.8% Case fatality rate of 19.1%. Conclusion According to the craniocerebral CT imaging features and the comprehensive analysis of the intracerebral and extracranial hematoma, the individualized treatment can improve the quality of life and prognosis, reduce the complications, reduce the morbidity and Case fatality rate.