临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (3): 201-205.

• 专家笔谈 •    下一篇

新生儿颅内出血后脑积水的治疗方法评价

俞丽君,林振浪   

  1. 温州医科大学附属第二医院 育英儿童医院新生儿科(浙江温州 325027)
  • 收稿日期:2014-01-24 出版日期:2014-03-15 发布日期:2014-03-15

Evaluation of the therapies for neonatal posthaemorrhagic hydrocephalus 

YU Lijun, LIN Zhenlang    

  1. (Department of Neonatology, The Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China)
  • Received:2014-01-24 Online:2014-03-15 Published:2014-03-15

摘要:

 早产儿颅内出血发生率较过去30年有明显降低,但随着超早早产儿存活数量的增多,严重颅内出血继发脑积水成为早产儿管理中的棘手问题之一。颅内出血后脑积水的治疗方法包括,反复腰椎穿刺放液、通过脑室储液囊反复放液、脑室-腹腔分流术、引流加灌洗和纤维溶解综合治疗、应用利尿剂减少脑脊液产生、脑室内纤维溶解治疗等。文章阐述颅内出血后脑积水的病理生理机制、不同干预措施的指征及其效果和安全性等。

Abstract: Although the percentage of preterm infants developing intraventricular haemorrhage (IVH) has been greatly reduced in the past three decades, increased survival of extremely preterms has meant that severe IVH with subsequent posthae-morrhagic hydrocephalus is still one of the serious unsolved problems for managements of preterms. Therapeutic interventions for posthaemorrhagic hydrocephalus include serial lumbar punctures, repeated aspiration through a ventricular access device, ventriculoperitoneal shunting, drainage, irrigation and fibrinolytic therapy, diuretic therapy treatment to reduce cerebrospinal fluid production, intraventricular fibrinolytic therapy, etc. This review summarizes the current concepts on the pathophysiology, intervention indications, and the effectiveness and safety of different interventions of subsequent posthaemorrhagic hydrocephalus.