快速细孔钻颅脑室置管引流术治疗脑室出血3571例临床分析  

Rapid pore cranial drilling and ventricular drainage treatment in ventricular hemorrhage： a clinical analysis of 3571 cases

作　　者：魏麟[1] 李刚[2] 金澎[3] 王成伟[4] 费昶[5] 王道奎[6] 王宝安 徐东方[8] 潘树茂[9] 辛昌明[10] 刘广存[1] 王吉华[11] 杜继海 谢波 张庆林[4] 

机构地区：[1]山东大学附属千佛山医院神经外科,济南250014 [2]山东大学齐鲁医院神经外科,济南250012 [3]青岛大学附属医院神经外科,青岛266071 [4]山东大学第二医院神经外科,济南250033 [5]临沂市人民医院神经外科,276000 [6]潍坊市人民医院神经外科,261500 [7]淄博市第一医院神经外科,255200 [8]德州市人民医院神经外科,253600 [9]烟台市毓璜顶医院神经外科,264000 [10]泰安市中心医院神经外科,271000 [11]济南市立三院神经外科,250014 [12]日照市莒县人民医院神经外科,276500 [13]荣成市第二医院神经外科,264309

出　　处：《中华神经医学杂志》2011年第7期731-734,共4页Chinese Journal of Neuromedicine

基　　金：山东省科技发展计划项目（2008GG10002095）：山东大学“985工程”三期神经外科建设项目（10000065950010）

摘　　要：目的总结应用快速细孔钻颅脑室置管引流术治疗脑室出血的临床效果和经验体会．评估快速吸孔钻颅器的性能。方法对山东省13家省、市、县及县分院应用快速细孔钻颅器钻颅脑室置管引流术治疗3571例脑室出血患者的临床资料（1977年至今）进行总结分析，并与传统的Dandy’S钻颅器进行比较。结果3571例患者的治愈率为27．1％，好转率为49．1％，死亡率为23．8％。快速细孔钻颅不须头皮切口，不用吸引器、电凝止血和特殊照明，只用钻头戳穿头皮、钻透颅骨和硬膜．置人引流管缝扎1针固定，一人在床边5min左右即可完成；传统的Dandy’s钻颅必须3人在手术室完成，需要二十余道操作程序，加上接送患者的时间至少需要60min以上；快速细孔钻颅器在操作程序、技术性能、手术条件和人员耗时等方面明显优于Dandy’S钻颅器。结论快速细孔钻颅器极大地简化了操作程序，节省了救治时间，为抢救重症患者赢得了时机，是提高疗效、降低死亡率的关键。35年的临床实践证明，在需要施行脑室体外引流抢救的重症患者中，快速细孔钻颅技术明显好于传统的Dandy’s钻颅术，是治疗此类疾病的有效方法。Objective To summarize the clinical effects and experiences of rapid pore cranial drilling and ventricular drainage treatment on ventricular hemorrhage to evaluate the performance of rapid pore cranial drilling. Methods The clinical data of 3571 patients with ventricular hemorrhage performed the rapid pore cranial drilling and ventricular drainage treatment from 13 hospitals of Shandong province since 1977 were retrospectively analyzed and concluded; these data were compared with those in patients received traditional Dandy＇s device. Results In these 3571 patients, the cure rate was 27.1%, the improvement rate was 49.1%, and the death rate was 23.8%. Rapid pore drilling needed no scalp incision, no suction, no coagulation, or no special lighting, only needed puncturing the scalp, drilling through the cranium and dura matter, implanting drainage tube and stitching it up; one can manage it in about 5 minutes at bedside; while the traditional Dandy＇s drilling occupied 3 people in the operating room, needed more than 20 procedures, and plus the time transporting the patient, it needed at least 60 minutes or more to finfish the procedures. Rapid pore cranial drill device is superior to Dandy＇s cranial drill device in operating procedures, technical performance, operation conditions, personnel and time-consuming. Conclusion Rapid pore cranial drilling greatly simplifies the operating procedures, saves precious time for the seriously ill patients, reduces the mortality and improves the effectiveness of the treatment. After 35 years of clinical practice, to those patients seriously ill needed ventricular drainage treatment to rescue their lives, rapid pore cranial drilling is superior to traditional Dandy＇s drill technic, and is an effective method treating such diseases.

关 键 词：脑出血 脑室 快速细孔钻颅 脑室引流 

分 类 号：R651.1[医药卫生—外科学]