侧脑室联合腰大池引流对重型脑室系统出血的疗效观察  

Observation of the effect of lateral ventricle combined with lumbar cistern drainage on patients with severe ventricular hemorrhage

作　　者：张永良 李飞翔[2] 张晓晓[3] 许梦雅[2] 岳璠 闻君 朱洪山[2] 李婧静 吴睿[2] ZHAGN Yongliang1, LI Feixiang2, ZHANG Xiaoxiao2, XU Mengya2, YUE Fan2, WEN Jun2, ZHU Hongshan2, LI Jingjing2 ,WU Rui2(1.Department of Neurosurgery ,the First People＇s Hospital of Ruzhou ,Ruzhou 467599, China ; 2. Department of Neuro-reha- bilitation , the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China; 3. Department of Neurology, the First People＇s Hospital of Zhengzhou, Zhengzhou 450000,Chin)

机构地区：[1]汝州市第一人民医院神经外科,河南汝州467599 [2]郑州大学第二附属医院神经康复科,河南郑州450014 [3]郑州市第一人民医院神经内科,河南郑州450000

出　　处：《中国实用神经疾病杂志》2018年第6期611-614,共4页Chinese Journal of Practical Nervous Diseases

基　　金：河南省卫生和计划生育委员会医学教育研究课题;项目编号:Wjlx2016062

摘　　要：目的比较双侧侧脑室联合腰大池引流与单侧侧脑室联合腰大池引流对重型脑室系统出血患者的疗效。方法回顾分析2010—2016年汝州市第一人民医院Graeb评分≥5分的76例重型脑室系统出血患者的临床资料,39例行双侧侧脑室联合腰大池引流的脑室系统出血患者为观察组,37例行单侧侧脑室联合腰大池引流的脑室系统出血患者为对照组,观察患者意识状态、脑室出血清除时间、并发症,术后1个月、2个月分别测评ADL分级、MMSE,术后6周测评GOS,观察疗效。结果手术2个月后,观察组ADL、MMSE评分较对照组显著提高(P<0.05);术后4周GOS评分,观察组良好12例,轻残20例,重残3例,植物生存1例,死亡3例;对照组良好5例,轻残13例,重残6例,植物生存5例,死亡8例,视良好和轻残为有效,观察组有效率82.05%,对照组为48.65%,差异有统计学意义(P<0.05)。结论双侧侧脑室联合腰大池引流较单侧侧脑室联合腰大池引流对于重型脑室系统出血的患者疗效更佳,可提高重型脑室系统出血患者的生活质量、认知功能和生存率。Objective To compare the effect of bilateral lateral ventricle and unilateral lateral ventricle combined with lum- bar cistern drainage for patients with severe ventricular hemorrhage. Methods The clinical data of 76 patients with severe intraventricular hemorrhage were retrospectively analyzed in 2010-2016 years in our hospital whose Graeb score more than 5,39 cases of bilateral lateral ventricle system combined with lumbar cistern drainage bleeding patients were divided into the observation group,37 patients underwent unilateral lateral ventricle ventricular system combined with lumbar cistern drainage of the patients were divided into control group, observed patient＇s consciousness, scavenging time of ventricular hemorrhage, postoperative complications, after 1 month and 2 months of operation respectively evaluation of ADL, MMSE, after 6 weeks of operation, GOS were evaluated,and the clinical efficacy was observed. Results Two months after the operation, the observation group＇s ADL, MMSE score was significantly higher than the control group （P〈0. 05） ;4 weeks after operation, the GOS score of the observation group, 12 cases were good, 20 cases of light disability, 3 cases of heavy disability,plant survival of 1 case, 3 cases of death; In the control group, 5 cases were good, 13 cases of light disability, 6 cases of heavy disability, 5 cases of plant survival and 8 cases of death. Good and light disability is effective, the effective rate of observation group was 82.05%, the eontrol group was 48.65%, the difference was statistically significant （P〈0.05）. Conclusion The bilateral lateral ventricle combined with lumbar cistern drainage is better than unilateral lateral ventricle combined with lumbar cistern drainage for severe intraventricular hemorrhage patients, can improve the severe intraventrieular hemorrhage patient＇s quality of life, cognitive function and survival rate.

关 键 词：侧脑室引流 腰大池引流 脑室系统出血 脑出血 ADL 

分 类 号：R743.34[医药卫生—神经病学与精神病学]