腰大池穿刺置管引流在脑室出血中的应用效果  

The effect of lumbar cistern drainage in ventricular hemorrhage

作　　者：梁曦[1] 汤树洪[1] 蔡恒森 黄超 梁敏[1] 

机构地区：[1]广西贵港市人民医院神经外科,贵港537100 [2]广西平南县第二人民医院神经外科,平南537100 [3]广西贵港市港北区人民医院神经外科,贵港537100

出　　处：《中国实用神经疾病杂志》2015年第10期10-11,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨腰大池穿刺置管引流应用辅助治疗脑室出血中的临床效果。方法选取2010-01—2014-07我院收治的脑室出血患者80例,采用随机数表法将所有患者分为治疗组与对照组,每组40例,无明显梗阻性脑积水,无其他严重的肝肾肺功能损害;对照组:脑室出血>60%,入院当天即行钻孔脑室外引流术,持续引流7d,7d后改为每日腰穿放脑脊液20mL。脑室出血<60%,入院第2天每日行腰穿放脑脊液20mL治疗;治疗组患者于入院后第2天接受腰大池穿刺置管持续性引流脑室内积血治疗。比较2组患者积血清除时间、病死率、继发性脑积水发生情况,并统计总有效率。结果治疗组患者在平均积血清除时间、病死率及脑积水发生率较对照组具有显著优势(P<0.05);治疗组总有效率明显高于对照组,差异具有统计学意义(P<0.05)。结论应用腰大池穿刺置管引流辅助治疗脑室出血具有创伤小、操作方便的优势,同时可持续性引流血性脑脊液,引流量较大并可调节控制速度流量,提高治疗的安全性与可靠性。Objective To discuss the clinical effect of lumbar cistern drainage in ventricular hemorrhage. Methods 80 pa‐tients with ventricular hemorrhage from January 2010 to July 2014 in our hospital were divided into the treatment group （n=40） and control group （n=40） by random number table methods ,all cases had no significant obstructive hydrocephalus and other serious liver and kidney damage. The patients with more than 60% bleeding volume in control group accepted intravent‐ricular external drainage on the day of admission ,and instead of initial 7‐day continuous drainage ,20 mL cerebrospinal fluid was drained everyday by lumbar puncture ,while others in control group accepted CSF drainage by lumbar puncture everyday from the second day in hospital. Patients in treatment group accepted continuous lumbar cistern drainage to treat hemorrhage.Hemorrhage clearing time ,mortality ,occurrence of secondary hydrocephalus were compared ,and the total effective rate was collected. Results Average hemorrhage clearing time ,mortality and the incidence of hydrocephalus in the treatment group pa‐tients showed more significant advantages over the control group （P〈0.05）;the total effective rate of the treatment group was obviously higher than that of the control group ,which had a statistical difference （P〈 0.05）. Conclusion Lumbar cistern drainage in treatment of intraventricular hemorrhage shows advantage in less trauma and easy operation ,and can continuously drain CSF and control velocity ,which improves the safety and reliability.

关 键 词：腰大池穿刺 脑室出血 脑室外引流术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]