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KMID : 0376119950220020305
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Medical Journal of the Red Cross Hospital
1995 Volume.22 No. 2 p.305 ~ p.312
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The Results of the Extraventricular Drainage Combined with Intraventricular Injection of Urokinase for the Intraventricular Hematomas
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정연선
김민호/이지영/심기법/홍승관
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Abstract
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The authors applied the extraventricular drainage combined with intermittent intraventricular injection of urokinase to the 21 patients with intraventricular hematoma and ventricular dilatation. 10,000IU of urokinase was injected every 12 hours
for
3
days. Follow-up CT on day 4 after the treatment showed complete disappearance of hematoma in the 3rd and 4th ventricles and small residual hematoma in occipital horns of lateral ventricles in the majority(14 patients). Obtruction of the drainage
catheter did not occur in any case, but transient pleocytosis in CSF, ventriculitis, and rebleeding complicated 6, 4, and 4 cases respectively. The duration of extraventricular drainage in the 17 patients without major complications was 3~17
days.
The
clinical results on discharge were good recovery in 3, moderate disability in 1, severe disability in 4, vegetative state in 6, and death in 7 cases. The decisive events that were thought to have caused vegetative states or death in the 13
patients
of
poor results were low initial GCS in 7, rebleeding in 4, ventriculitis in l, pneumonia in 1, and unknown in l cases.
The method of the extraventricular drainage combined with intermittent intraventricular injection of urokinase seems useful in removing intraventricular hematomas more rapidly. Regarding various other factors influence the clinical course of
severe
intraventricular hematomas, further investigation including prospective studies in necessary to determine whether the intraventricular injection of urokinase significantly improve the final outcomes of theose patients with severe intraventricular
hematomas.
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KEYWORD
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