CAJ | 학술논문

目的：探讨颅内压监护在自发性脑室出血后脑积水的应用价值，以及腰大池引流用于治疗脑室出血后交通性脑积水的可行性。方法对6例自发性脑室出血行双侧脑室外引流术，术后持续颅内压监护，脑室内尿激酶灌注，第三、四脑室积血消失后关闭脑室外引流管，若出现颅内压持续升高则行腰大池引流术。结果6例关闭脑室外引流后颅内压均持续升高，6例预后良好，GOS 5分4例，GOS 4分2例，无1例需行脑室腹腔分流术。结论应用脑室外引流术后颅内压监护可发现脑室出血后交通性脑积水，腰大池引流结合脑室内纤溶治疗可尽早清除脑室内血凝块，可用于脑室出血后脑积水的治疗。
목적：탐토로내압감호재자발성뇌실출혈후뇌적수적응용개치，이급요대지인류용우치료뇌실출혈후교통성뇌적수적가행성。방법대6례자발성뇌실출혈행쌍측뇌실외인류술，술후지속로내압감호，뇌실내뇨격매관주，제삼、사뇌실적혈소실후관폐뇌실외인류관，약출현로내압지속승고칙행요대지인류술。결과6례관폐뇌실외인류후로내압균지속승고，6례예후량호，GOS 5분4례，GOS 4분2례，무1례수행뇌실복강분류술。결론응용뇌실외인류술후로내압감호가발현뇌실출혈후교통성뇌적수，요대지인류결합뇌실내섬용치료가진조청제뇌실내혈응괴，가용우뇌실출혈후뇌적수적치료。
Objective To study the application value of ICP (intracranial pressure) monitoring in the hydrocephalus after IVH (intraventricular hemorrhage) as well as the feasibility of LD (lumbar drainage) in the treatment of communicating hydro‐cephalus after ventricular hemorrhage.Methods 6 IVH cases received the bilateral EVD (external ventricular drainage) and continuously took the ICP monitoring after surgery. The urokinase was perfused into cerebral ventricle. After the disappearance of 3rd and 4th ventricular hemorrhage ,EVD tube was closed.If ICP was continuously increased ,LD was applied.Results Af‐ter EVD ,ICP for 6 cases was continuously increased.The prognosis was favorable.Based on GOS ,there were 4 cases with 5 scores and 2 cases with 4 scores. The ventriculoperitoneal shunt was not applied.Conclusion After EVD ,ICP monitoring can detect the communicating hydrocephalus after ventricular hemorrhage.LD combined with ventricular fibrinolysis therapy can e‐liminate the ventricular blood clot as soon as possible. It can be applied to treat the hydrocephalus after ventricular hemorrhage.