改良护脑双腔引流管在慢性硬膜下血肿外引流术中的应用  

Application of modified brain protection double-lumen drainage tube in external drainage of chronic subdural hematoma

作　　者：孙涛[1] 韩易[1] 姜之全[1] 张少军[1] 娄飞云[1] 郑夏林[1] 张弢[1] 李小绪 李磊[1] 董小辉 孙季威 Sun Tao;Han Yi;Jiang Zhiquan;Zhang Shaojun;Lou Feiyun;Zheng Xialin;Zhang Tao;Li Xiaoxu;Li Lei;Dong Xiaohui;Sun Jiwei(Department of Neurosurgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院神经外科,安徽省蚌埠市233004

出　　处：《中华医学杂志》2018年第45期3681-3685,共5页National Medical Journal of China

基　　金：蚌埠医学院自然科学基金项目(BYKY1669);安徽省卫生计生委科研计划项目全科医学临床科研课题(2016QK052)。

摘　　要：目的 比较改良双腔引流管与传统硅胶管在慢性硬膜下血肿置管外引流术中的临床效果.方法 选取蚌埠医学院第一附属医院神经外科2016年7月至2018年6月收治的慢性硬膜下血肿需要手术的患者49例行钻孔置管外引流术,随机分为试验组(采用改良护脑双腔引流管23例)和对照组(使用传统硅胶引流管26例),对比两组患者术后血肿残余量、置管时间、引流管接触脑组织和蛛网膜例数、感染例数、术后癫痫发生例数、改良Rankin量表分值变化等指标.结果 试验组拔管时血肿残余量(13 ±7) ml,对照组(17 ±8) ml,两组患者在拔管时血肿残余量差异无统计学意义(P>0.05);引流管留置时间,试验组(2.0 ±0.9)d,对照组(2.7 ±0.8)d,两组比较差异有统计学意义(P<0.05);试验组无出现引流管接触脑组织和(或)蛛网膜患者,对照组出现引流管接触脑组织和(或)蛛网膜7例;两组均无发生感染例数;两组患者术前均无癫痫发生例数,试验组术后发生癫痫0例,对照组1例.两组各自手术前后改良Rankin量表分值变化比较差异均有统计学意义(均P<0.001),两组患者术后改良Rankin量表分值比较差异无统计学意义.结论 改良护脑双腔引流管在慢性硬膜下血肿置管外引流术中引流效果良好,留管时间短,引起并发症少,是治疗慢性硬膜下血肿安全有效的工具,值得临床推广.Objective To compare the clinical effects of modified double-lumen drainage tube and traditional silicone tube in external drainage of chronic subdural hematoma.Methods Selected 49 patients suffering from chronic subdural hematoma hospitalized in the Department of Neurosurgery , the First Affiliated Hospital of Bengbu Medical College between July 2016 and June 2018 who underwent external drainage , and divided them randomly into experimental groups (using modified brain protection double lumen drainage tube in 23 cases ) and control group ( using traditional silicone drainage tube in 26 cases ).Comparison of postoperative hematoma residual volume , the tube indwelling time , the numbers of drainage tube contact with brain tissue and arachnoid membrane , the numbers of infections , the numbers of postoperative epilepsy cases, and changes in Modified Rankin Scale scores between the two groups.Results At the time of extubation, the residual amount of hematoma in the experimental group was (13 ±7) ml, and that in the control group was (17 ±8) ml.There was no significantly statistical difference in the residual amount of hematoma between the experimental group and the control group (P＞0.05).The tube indwelling time of the experimental group was ( 2.0 ±0.9 ) days, and that of the control group was ( 2.7 ±0.8 ) days.The difference between the experimental group and the control group in the drainage tube indwelling time was statistically significant (P＜0.05).No cases of drainage tube contact with brain tissue and /or arachnoid membrane appeared in the experimental group , and 7 cases of drainage tube contact with brain tissue or arachnoid membrane appeared in the control group.No infection occurred in both groups.No cases of epilepsy occurred in preoperative , and there were 0 cases of epilepsy in the experimental group and 1 case in the control group in postoperative.There were significantly statistical differences in each of the two groups in the modified Rankin scale before and after surgery ( P＜0.001), ther

关 键 词：血肿 硬膜下 慢性 引流术 外科手术 

分 类 号：R651.1[医药卫生—外科学]