| 邬迎喜,贺世明,陆 丹,赵兰夫,王 元,薛亚飞,张玉富,赵天智.脑室出血合并脑积水行脑室外引流高危因素的临床分析[J].,2017,17(16):3064-3067 |
| 脑室出血合并脑积水行脑室外引流高危因素的临床分析 |
| Clinical Analysis of Risk Factors for Hydrocephalus Patients after Intraventricular Hemorrhage in Exerting External Ventricular Drainage |
| 投稿时间：2016-11-03 修订日期：2016-11-30 |
| DOI：10.13241/j.cnki.pmb.2017.16.016 |
| 中文关键词: 脑室内出血 脑积水 脑室外引流术 脑出血 |
| 英文关键词: Intraventricular hemorrhage Hydrocephalus External ventricular drainage Intracerebral hemorrhage |
| 基金项目:陕西省自然科学基金项目（S2015YFJQ1250） |
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| 中文摘要: |
| 摘要 目的：探讨脑室出血后未立即行脑室外引流术发生脑积水的指征和时机。方法：回顾性分析2009年1月到2015年9月我院收治的98例脑室内出血患者的临床资料。结果：98例患者中，28例(28.6%)患者需要行脑室外引流术。全脑室出血是最常见的类型(49例，50%)，这些患者中24例(49%)需要行脑室外引流术。在脑室外引流术组和非脑室外引流术组平均mGS分别是17±5.1(12-28)和 8±4.2 (2-20)(P＜0.001)。与脑室外引流术相关的因素包括影像学表现为脑积水、中线移位> 5 mm、 GCS评分< 8分、mGS >13分、三脑室mGS=5及四脑室mGS=5分。多因素回归分析中，mGS >13分、GCS评分< 8分和四脑室mGS = 5分仍是重要的影响因素。大部分患者(24例,85.7%)在有脑积水症状时很快行脑室外引流术，有4例患者在48小时后行脑室外引流术。结论：昏迷、mGS >13分和四脑室扩大使行脑室外引流术的风险增大。大部分患者在脑室出血后一天内行脑室外引流术，很少一部分患者在48小时后行脑室外引流术。 |
| 英文摘要: |
| ABSTRACT Objective: To discuss and examine the indicators and time for hydrocephalus patients who were not immediately treated with external ventricular drainage (EVD) after intraventricular hemorrhage (IVH). Methods: Retrospective analysis of clinical data of 98 cases of IVH from January 2009 to september 2015. Results: Ninety-eight patients met the criteria; twenty-eight (28.6%) received EVD. Paraventricular hemorrhage was the most common pattern (49.5%), with twenty-four in these patients requiring EVD. The median mGS in the EVD group was 17±5.1 (12-28) and was 8±4.2 (2-20) (p<0.001) in the No-EVD group. Hydrocephalus diagnosed by imaging, midline shift > 5 mm, Glasgow Coma Scale (GCS) score< 8, mGS > 13, third ventricle mGS = 5, and fourth ventricle mGS = 5 were associated with EVD. On multivariate regression analysis, mGS >13, GCS score< 8 and fourth ventricle mGS = 5were still significant factors. Most patients (24, 85.7%) who were symptomatic hydrocephalus received EVD soon. Only four patients received EVD after forty-eight hours. Conclusion: Coma, mGS >13 and a dilated fourth ventricle increased the risk of EVD. Most patients experienced EVD within 24 hours after IVH, and a minority required EVD after 48 hours. |
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