腰大池持续外引流治疗外伤性蛛网膜下隙出血的临床研究  

The clinical study of lumbar cistern continuous drainage in the treatment of traumatic subarachnoid hemorrhage

作　　者：李深誉[1] 严峻[1] 黄蕃俊 陈前[1] 吴修富[1] 韦开亮 阳永东[1] Li Shenyu Yan Jun Huang Fanjun et al(Department of Neurosurgery Gui lin Meakcal College Second Affiliated Hospital,Guilin, 541000, China.)

机构地区：[1]桂林医学院第二附属医院神经外科,桂林541000

出　　处：《立体定向和功能性神经外科杂志》2016年第5期306-309,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：广西急诊与医学救援人才小高地开放性课题资助项目(编号:GXJZ201422);广西医药卫生自筹经费计划课题(编号:Z2016037)

摘　　要：目的探讨持续腰池引流治疗外伤性蛛网膜下隙出血（tSAH）的疗效。方法回顾性分析于2010年9月～2016年2月在我院住院治疗的144例外伤性蛛网膜下隙出血患者的临床资料，数字法随机分为两组。观察组患者给予腰大池持续外引流治疗，对照组患者则给予反复腰穿治疗，观察并对比两组的临床疗效与预后。结果临床恢复情况观察组患者明显优于对照组，差异具有统计学意义（P〈0．05）。同时，观察组脑积水、继发癫痫与再出血发生率明显低于对照组，差异显著（P〈0．05）。两组G0s评分比较，观察组预后良好率明显高于对照组（P〈0．05）。结论腰大池持续外引流术大大避免了反复腰穿的繁琐，可有效缓解患者头痛、快速清除血性脑脊液、缩短住院时间、改善预后，且病情恢复快、并发症少，值得临床推广。Objective To observe the clinical effect of tr eating traumatic subarachnoid hem orrhage （ tSAH ） by contining drainage of eerebraspinal fluid （ C. S. F） in lumbar cistern. Methods Retrospective analysis of clinical data of 144 cases of traumatic subarachnoid hemor- rhage in our hospital treatment in September 2010--February 2016, divided into two groups according to the random number table o The observation group was treated with lumbar cistern con- tinuous drainage, while the control group was treated with lumbar puncture. The efficacy of the two groups after treatment were compared. Results The clinical recovery of the observation group,was significantly better than the control group, and the difference is statistically significant （P〈0.05）. At the same time,observation group hydrocephalus,secondary epilepsy and rebleed- ing rate was significantly lower than that in the control group,the difference is significant （P〈 0.05）. The GOS scores of the two groups compared to observe the good rate of the group, the prognosis was significantly higher than that of control group （P〈0.05）. Conclusion The lumbar cistern continuous drainage was simple, and could avoid the repeated lumbar puncture of trival, can effectively relieve headache, rapid removal of hemorrhagic cerebrospinal fluid, shorten the hos- pitalization time, improve prognosis, and rapid recovery, fewer complications, worthy of clinical promotion.

关 键 词：腰大池持续外引流 反复腰穿 外伤性蛛网膜下腔出血 

分 类 号：R743.35[医药卫生—神经病学与精神病学]