Arch Dis Child. 1990 Jan;65(1 Spec No):3-10. doi: 10.1136/adc.65.1_spec_no.3.
Treatment of posthaemorrhagic ventricular dilatation by early repeated cerebrospinal fluid taps was compared with conservative management in a randomised controlled trial of 157 infants in 15 centres. Thirty infants died and six moved abroad before follow up. During the first 14 days after randomisation, the early treatment group had five times more taps, and 12 times more cerebrospinal fluid removed. Infection of the cerebrospinal fluid occurred in seven of the early treated and four of the conservatively managed infants. Of survivors, 62% in both groups ultimately had ventricular shunts. Neurodevelopmental assessment of survivors at 12 months was carried out by a single experienced examiner. Of survivors, 103 (85%) had abnormal neuromotor signs and 88 (73%) had disabilities. There was no detectable benefit of early treatment for children who did not have parenchymal lesions at the time they entered the trial. Nearly all those with parenchymal lesions had neuromotor impairment, but early treatment was associated with a significant reduction in other impairments.
在一项针对15个中心的157名婴儿的随机对照试验中，对早期反复进行脑脊液穿刺治疗出血后脑室扩张与保守治疗进行了比较。30名婴儿死亡，6名在随访前移居国外。在随机分组后的前14天内，早期治疗组的穿刺次数多5倍，脑脊液排出量多12倍。早期治疗的婴儿中有7例发生脑脊液感染，保守治疗的婴儿中有4例发生感染。在幸存者中，两组最终均有62%接受了脑室分流术。由一名经验丰富的检查人员对幸存者在12个月时进行神经发育评估。在幸存者中，103例（85%）有异常神经运动体征，88例（73%）有残疾。对于在进入试验时没有实质病变的儿童，早期治疗没有可检测到的益处。几乎所有有实质病变的儿童都有神经运动障碍，但早期治疗与其他障碍的显著减少有关。
