外伤标准大骨瓣开颅术后应用腰大池引流术的临床研究  

Standard large-flap craniotomy combined with continuous lumber drainage of cerebrospinal fluid

作　　者：陈秋明 冯志铁 王汝飞 邵强 吴波 关则俭 吴分浪 卓华强 

机构地区：[1]广东省阳江市人民医院神经外科,529500

出　　处：《中华神经医学杂志》2006年第8期829-831,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨颅脑外伤标准大骨瓣开颅术后腰大池持续脑脊液引流术对重型颅脑损伤合并广泛性蛛网膜下腔出血的治疗效果。方法对急性重型颅脑损伤患者(GCS≤8)外伤性标准大骨瓣开颅术后,治疗组早期进行腰大池持续脑脊液引流术,对照组采用常规腰穿术,比较两组预后,分析其疗效。结果随访6个月,治疗组GOS恢复优于对照组,脑积水的发生率低于对照组。结论颅脯外伤标准大骨瓣开颅术后早期应用腰大池持续脑脊液引流术对重型颅脑损伤合并广泛性蛛网膜下腔出血患者可以提高治愈率,减少死亡率,降低脑积水的发生率,疗效好,安全性高。Objective To evaluate the therapeutic efficacy of standard large-flap craniotomy in combination with early continuous lumbar drainage of cerebrospinal fluid （CSF） in the treatment of severe head injury complicated by extensive subarachnoid hemorrhage. Methods Patients with acute severe head injuries and subarachnoid hemorrhage （GCS ≤ 8） were assigned to treatment group and control group. Both received standard large-flap craniotomy, after that the former received early continuous lumbar drainage of CSF; the latter was treated with traditional lumbar puncture and CSF drainage. The therapeutic results were compared and analyzed. Results During 6-month follow-up, the GOS improvement rate in the treatment group was higher than that in the control group, while the incidence of hydrocephalus was obviously lower in the treatment group than that in the control group. Conclusion Standard large-flap craniotomy in combination with early continuous lumbar drainage of CSF would increase the cure rate, reduce the mortality rate, and decrease the incidence of hydrocephalus in the patients with severe head injuries and extensive subarachnoid hemorrhage.

关 键 词：标准外伤大骨瓣术 脑脊液引流术 

分 类 号：R651[医药卫生—外科学]