不同引流管与置管方法治疗脑室内铸型血肿疗效比较  

Comparison of the effect of different methods of drainage tube and catheter drainage in the treatment of in- traventricular hematoma

作　　者：方乃成[1] 赵明[1] 杜国森[1] 王马军[1] 金星火[1] 潘柏林[1] 韦超[1] 徐铁峰[1] 王宁[1] 王超[1] 

机构地区：[1]温州医学院附属诸暨医院神经外科诸暨市人民医院神经外科,浙江省诸暨311800

出　　处：《中国基层医药》2012年第6期833-835,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的比较采用不同引流管与置管方法治疗脑室内铸型血肿的疗效。方法按随机原则，将83例脑室内铸型血肿患者分成观察组48例，采用弹头形大口径多孔引流管侧脑室联合置管引流术；对照组35例，采用常规应用的脑室外引流管侧脑室前角置管引流术，术后对两组病例脑室内血肿清除率和治疗结果进行监测和分析。结果术后〈24h、24—72h、〉72h等不同时间点，观察组脑室内血肿清除率分别为27．1％（13／48）、50．0％（24／48）、14．6％（7／48），与对照组的5．7％（2／35）、17．1％（6／35）、48．6％（17／35）等差异均有统计学意义（x2=6．2425、9．4678、11．3757，均P〈0．01）。治疗后，观察组ADL分级I级47．9％明显高于对照组的20．0％（x2=6．8347，P〈0．01），观察组病死率12．5％，低于对照组的37．1％（x2=6．9636，P〈0．01）。结论弹头形大口径多孔引流管能避免引流管堵塞，侧脑室联合置管术有利于脑室内血肿的引流性治疗，在脑室内铸型血肿患者中应用能显著提高治疗效果。Objective To explore the effect of different methods of drainage tube and catheter drainage in the treatment of intraventricular hematoma. Methods The analysis was conducted in 83 cases, who were randomly divided into two groups, the treatment group with 48 cases adopting lateral venticle catheterization combined with bulletshaped tube, and the control group with 35 cases adopting conventional catheterization. The contrasted study was conducted on the clearance rate of cerebroventricular hematoma and the effect of the different drainages. Results The clearance rate in treatment group was 27.1% （ 13/48 ） ,50. 0% （ 24/48 ）, 14.6% （ 7/48 ）, at the time of 〈 24h, 24 72h, 〉 72h after the operation, and 5.7 % （ 2/35 ）, 17.1% （ 6/35 ） ,48.6% （ 17/35 ） in the control group. It showed sta- tistical significance（ X2 = 6. 2425,9. 4678,11. 3757, all P 〈 0.01 ）. The cases with type I of ADL stage in treatment group （47.9%） were more than control group（ X2 = 6. 8347,P 〈 0. 01 ）. The morbidity in treatment group was 12. 5%, which was lower than control group（ X2 = 6. 9636 ,P 〈 0.01 ）. Conclusion The lateral venticle catheterization drainage combined with bullet-shaped tube could avoid the obstruction, reduce the morbidity, and improve the therapeutic effect.

关 键 词：血肿 硬膜下 颅内 脑室造口术 引流术 

分 类 号：R651.1[医药卫生—外科学]