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目的:探讨在行脑室外引流(extraventricular drainage,EVD)的重度脑室出血患者中应用rt-PA治疗对ICP的控制效果。方法:从包括北京大学深圳医院在内的深圳市三家医院内与神经外科合作随机选出122例阻塞性脑室内出血且进行脑室外引流急救的患者,随机分成脑室内重组组织型纤溶酶原激活剂(rt-PA)治疗组(n=97)以及阴性对照组(未予溶栓)(n=25),比较rt-PA治疗对于颅内压升高的影响。结果:rt-PA治疗组患者ICP升高程度低于对照组,且脑室血肿清除天数明显低于对照组。结论:溶栓治疗联合脑室外引流能明显控制IVH患者颅内压的升高,且有助于脑室血肿的清除,具有一定的临床意义,可扩大病例数进行大样本的验证。
Objective: To investigate the effect of rt-PA on ICP in patients with severe intraventricular hemorrhage with extraventricular drainage (EVD). Methods: A total of 122 patients with obstructive intraventricular hemorrhage and emergency first-aid for ventricular drainage were randomly selected from three hospitals in Shenzhen City, including Shenzhen University Hospital of Peking University. The patients were randomly divided into intraventricular recombinant plasminogen activator The effect of rt-PA treatment on intracranial pressure was compared between the treatment group (rt-PA) (n = 97) and the negative control (no thrombolysis) (n = 25). Results: The ICP level in the rt-PA group was lower than that in the control group, and the number of days of ventricular hematoma clearance was significantly lower than that in the control group. Conclusion: Thrombolysis combined with intraventricular drainage can significantly control the intracranial pressure in patients with IVH elevation, and contribute to the clearance of intraventricular hematoma has a certain clinical significance, the number of cases can be expanded to verify large samples.