持续腰大池引流对迟发性脑积水的作用研究  

Role of lumbar subarachnoid continuous drainage in delayed hydrocephalus

作　　者：张学广[1] 程刚 马子勇[1] 焦盈盈[1] 张志逖[1] 侯磊[1] 种宗雷[1] 

机构地区：[1]聊城市人民医院神经外科,252000 [2]聊城市第四人民医院外科,252000

出　　处：《中华神经医学杂志》2015年第4期516-518,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨持续腰大池引流对脑外伤患者去骨瓣减压术后迟发性脑积水的治疗作用。方法收集自2009年6月至2013年09月聊城市人民医院神经外科收治的32例脑外伤去骨瓣减压术后恢复期发生迟发性脑积水患者的临床资料；所有患者行持续腰大池置管引流，分析其治疗效果。结果腰大池置管引流后，14例患者首个引流周期顺利拔出腰大池引流管，5例患者2个引流周期后顺利拔出腰大池引流管，均免除行脑室一腹腔分流手术；另13例患者发展为分流依赖性脑积水，行脑室-腹腔分流手术治疗后比较；置管引流期间无1例发生中枢神经系统感染。结论持续腰大池置管引流具有创伤小、易操作等优点，能减少迟发性脑积水向分流依赖性脑积水的发生率。Objective To investigate the treatment effect of lumbar subarachnoid continuous drainage on delayed hydrocephalus in patients with cerebral trauma after decompressive craniectomy. Methods Thirty-two patients with delayed hydrocephalus after decompressive craniectomy, admitted to our hospital from June 2009 to September 2013, were treated by lumbar subarachnoid continuous drainage; and the treatment effect was analyzed. Results After lumbar subarachnoid continuous drainage, 14 patients got successful drainage tube being extracted in the first period, 5 were in the second cycle; they all got avoidance ofventriculo peritoneal shunt operation. However, the other 13 patients, developed into shunt dependent hydrocephalus, were treated with ventriculoperitoneal shunt operation. No central nervous system infections were noted during the period of draining. Conclusion The treatment of lumbar subarachnoid continuous drainage, with the characteristics of small trauma and easy operating, can reduce the incidence of shunt dependent hydrocephalus, which is developed by delayed hydrocephalus.

关 键 词：腰大池引流 迟发性脑积水 去骨瓣减压术后 分流依赖性脑积水 

分 类 号：R651.1[医药卫生—外科学]