腰大池持续外引流治疗出血性脑卒中破入脑室的临床观察  

Clinical Observation of External Lumbar CSF Drainage Treatment on Intra-ventricular Hemorrhage

作　　者：林健[1] 林茂晖[1] 刘水源[1] 刘盛泽[1] 

机构地区：[1]厦门大学附属福州第二医院神经外科,福建福州350007

出　　处：《康复学报》2015年第3期46-49,共4页Rehabilitation Medicine

基　　金：福建省自然科学基金项目(2012J01429);福州市卫生计生系统科技计划项目(2015-S-WQ8)

摘　　要：目的:探讨腰大池置管持续外引流在出血性脑卒中破入脑室治疗中的临床疗效。方法:回顾性分析2012年6月至2015年6月我科收治的出血性脑卒中破入脑室患者46例,依据不同的治疗方式分成2组,其中观察组25例,行腰大池外引流治疗,采用美敦力EDMS腰大池持续外引流系统,调节控制引流量,每日120~200 m L,分3~4次释放,持续引流7 d;对照组21例,采取常规保守治疗,未行腰大池外引流。结果:观察组患者未出现颅内感染,平均住院时间14 d,出院时头颅CT复查显示:25例脑内及脑室内血肿均完全吸收,其中只有3例出现脑积水,行侧脑室-腹腔分流术后治愈。对照组患者平均住院时间29.5 d,出院时头颅CT复查显示:21例脑内及脑室内血肿基本吸收,其中8例出现脑积水,行侧脑室-腹腔分流术后治愈。结论:对于出血性脑卒中破入脑室的患者,选择性行腰大池置管持续外引流治疗,可以减少脑积水的发生率,缩短住院时间。Objective:To assess the clinical effect of external lumbar CSF drainage treatment on intraventricular hemorrhage.Methods:A retrospective review was conducted for 46 patients with intraventricular hemorrhage from June 2012 to June 2015. They were divided into observation group and control group depending on different treatment plans. Twenty-five patients in the observation group underwent lumbar CSF drainage treatment by Medtronic EDMS external lumbar CSF drainage system,with the method of controlling the flow of CSF of seven days,120-200 m L per day divided into 3-4 times. Twenty-one patients in the control group did not accept lumbar CSF drainage treatment. Results:Observation group did not develop intracranial infection,the average hospitalized days for 14 days,CT showed all the hematoma were completely absorbed,only three patients appeared hydrocephalus but cured with ventriculo-peritoneal shunt. The average hospitalized days of control group were 29.5 days,all the hematoma were completely absorbed showed by CT,among eight patients appeared hydrocephalus but cured with ventriculo-peritoneal shunt. Conclusion:The patients with intraventricular hemorrhage whom underwent lumbar CSF drainage treatment could improve the clinical treatment effect by reducing incidence rate of hydrocephalus and then shortening hospitalized days.

关 键 词：出血性脑卒中 腰大池持续引流 脑室 脑积水 平均住院天数 

分 类 号：R651.1[医药卫生—外科学]