腰大池引流在外伤性蛛网膜下腔出血中的临床研究  

Clinical Study on Lumbar Continous Drainage in Traumatic Subarachnoid Hemorrhage

作　　者：郑涛[1] 刘旭[1] 廖洪民[1] 黄建军[1] 

机构地区：[1]贵州航天医院神经外科,贵州遵义563003

出　　处：《中国伤残医学》2014年第23期12-13,共2页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨腰大池引流在外伤性蛛网膜下腔出血中的临床效果。方法：选择我院2009年12月∽2011年12月外伤性蛛网膜下腔出血患者共83例，上述患者随机分为观察组和对照组。2组患者均各有常规处理。对照组患者在伤后第3天实施腰椎穿刺放出血性脑脊液处理，观察组患者在伤后第3天实施腰椎穿刺，行持续性外引流。观察2组患者伤后1周内头痛的缓解情况；观察2组患者伤后1周内的恶心呕吐缓解情况；随访观察伤后1年内脑积水的发生情况。结果：观察组患者置管外引流后伤后头痛、恶心呕吐等症状均得到显著缓解，其中脑脊液检查显示1例出血颅内感染，给予敏感抗生素后感染控制，恢复正常，对照组患者患者在伤后头痛、恶心呕吐等症状得到不同程度缓解。观察组伤后1周内头痛、恶心呕吐缓解情况显著优于对照组，差异有统计学意义（P＜0．05）；观察组伤后1年内脑积水发生率与对照组比较，差异有统计学意义（P＜0．05）。结论：外伤性蛛网膜下腔出血早期实施腰大池持续引流能够显著改善患者头痛、恶心、呕吐等症状，远期效果较好，值得借鉴。Objective：To discuss the clinical effect of lumbar continous drainage in traumatic subarachnoid hemorrhage .Methods：83 cases with traumatic subarachnoid hemorrhage from Dec .2009 to Dec.2011 were randomly divided into observation group and control group.Both groups were given conventional treatment .Control group was performed lumbar puncture to discharge blood cerebrospinal fluid in the third day of trauma , while observation group was performed umbar continous drainage .The remission of headache , nausea and vom-iting were observed after 1 week, and the incidence of hydrocephalus was followed up in 1 year.Result：Patients＆#39;symptoms such as head-ache, nausea and vomiting were significantly alleviated in observation group .1 case had intracranial infection by cerebrospinal fluid exam-ination, but returned to normal after given sensitive antibiotics .Patients in control group had different alleviation of headache , nausea and vomiting.The remission in observation group were superior to control group in 1 week, the difference had statistical significance （P〈0. 05）;for the incidence of hydrocephalus in 1 year, the difference of two groups had statistical significance （P〈0.05）.Conclusion：The early performance of lumbar continous drainage in traumatic subarachnoid hemorrhage can significantly improve patients ＆#39;symptoms such as headache , nausea and vomiting .It has good long term effect and worth of learning .

关 键 词：外伤性蛛网膜下腔出血 腰大池持续引流 脑积水 

分 类 号：R651.1[医药卫生—外科学]