重型颅脑损伤去骨板减压术后早期腰椎穿刺术与继发性脑积水的关系  

Analysis of relationship between early lumbar puncture and the incidence of secondary postoperative hydrocephalus in patients with severe traumatic brain injury

作　　者：曹轲[1] 段兴浩 刘玉飞[1,2] 冯进[1] 徐兴国[1] 陈一笑 马辉[3] 李宗正[3] 

机构地区：[1]宁夏医科大学,银川750004 [2]深圳市第二人民医院神经外科,广东518035 [3]宁夏医科大学总医院神经外科,银川750004

出　　处：《中国临床神经外科杂志》2015年第9期535-537,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨早期腰椎穿刺术(LP)预防重型颅脑损伤(STBI)去骨板减压术后继发性脑积水的效果。方法回顾性分析2010年6月至2013年6月收治的107例STBI患者的临床资料,均行开颅去骨瓣减压术,术后早期LP治疗48例(LP组),未给予LP干预59例(对照组)。结果 LP术后5例(10.4%)发生脑积水,其中急性脑积水2例(4.2%),亚急性脑积水2例(4.2%),慢性脑积水1例(2.1%)。对照组术后22例(37.3%)发生脑积水,其中急性脑积水11例(18.6%),亚急性脑积水10例(16.9%),慢性脑积水1例(1.7%)。两组脑积水总发生率、急性脑积水发生率和亚急性脑积水发生率均有统计学差异(P<0.01)。结论 STBI患者去骨板减压术后早期辅以LP可有效降低术后急性脑积水和亚急性脑积水的发生率,而对慢性脑积水的无明显影响。Objective To investigate the effect of early lumbar puncture （LP） on the secondary postoperative hydrocephalus in patients with severe traumatic brain injury （sTBI）. Methods The clinical data of 107 patients with sTBI, who were treated in our hospital from June, 2010 to June, 2013, were analyzed retrospectively. Of 107 patients, 48 （observed group） received lumber puncture early after the operation and 59 （control group） not. The incidences of postoperative hydrocephalus were compared between both the groups. Results The total incidence of the postoperative hydrocephalus （10.42%, 5/48） was significantly lower in the observed group than that （37.29%, 22/59） in the control group （P〈O.01）. The incidences of the postoperative hydrocephalus in the acute and subacute phases were significantly lower in the observed group than those in the control group （P〈0.05）. There was insignificant difference in thb incidence of the postoperative hydrocephalus in the chronic phase between both the group （P〈0.05）. Conclusion The incidences of postoperative hydrocephalus including total, and acute and subaeute phases incidences can be reduced by the lumber puncture early after the operation in the patients with sTBI.

关 键 词：重型颅脑损伤 去骨板减压术 腰椎穿刺术 继发性脑积水 效果 

分 类 号：R651.15[医药卫生—外科学] R651.11[医药卫生—临床医学]