开颅术后腰大池持续引流对重型颅脑损伤伴SAH患者血性脑脊液水平及神经功能的影响  

Effect of continuous drainage of lumbar cistern after craniotomy on hemorrhagic cerebrospinal fluid level and nerve function of patients with severe craniocerebral injury combined with SAH

作　　者：郭威 杨东斌 高形国 GUO Wei;YANG Dongbin;GAO Xingguo(Hebi People's Hospital,Hebi 458030,Henan)

机构地区：[1]鹤壁市人民医院,河南鹤壁458030

出　　处：《菏泽医学专科学校学报》2020年第3期9-11,42,共4页Journal of Heze Medical College

摘　　要：目的探讨开颅术后腰大池持续引流对重型颅脑损伤伴蛛网膜下腔出血(SAH)患者血性脑脊液水平及神经功能的影响。方法将我院收治的84例重型颅脑损伤伴SAH患者随机分为对照组和观察组,每组42例。两组均行开颅手术,对照组术后予以多次腰穿引流,观察组术后予以腰大池持续引流,两组均持续引流至脑脊液清亮且生化检查均正常。观察两组不同时间点血性脑脊液计数、神经功能、大脑中动脉平均流速及并发症情况。结果治疗后,观察组脑脊液红细胞计数、加拿大神经功能评分量表(CNS)评分和大脑中动脉平均流速较对照组低(P<0.05);观察组术后1个月并发症发生率较对照组低(P<0.05)。结论术后腰大池持续引流可降低重型颅脑损伤伴SAH患者血性脑脊液水平,改善神经功能、降低大脑中动脉平均流速及降低并发症发生率。Objective To explore the effect of continuous drainage of the lumbar cistern after craniotomy on hemor⁃rhagic cerebrospinal fluid level and nerve function of patients with severe craniocerebral injury combined with subarachnoid hemorrhage(SAH).Methods Eighty-four patients with severe craniocerebral injury combined with SAH treated in our hospital were selected and randomly divided into the control group and the observation group,42 cases in each group.The control group received multiple lumbar puncture drainage and the observation group received continuous drainage of lumbar cistern.The drainage lasted until cerebrospinal fluid was clear and biochemical examination was normal.The blood cerebro⁃spinal fluid level,nerve function,mean flow rate of the middle cerebral artery and complications of the two groups were ob⁃served at different time points.Results After treatment,the cerebrospinal fluid red blood cell count of the observation group was lower than that of the control group(P<0.05);the Canadian Neurological Function Rating Scale(CNS)score of the observation group was lower than that of the control group(P<0.05);the mean flow rate of the middle cerebral artery was slower than that in the control group(P<0.05);the incidence rate in the observation group was lower than that in the control group(P<0.05).Conclusion The continuous drainage of lumbar cistern after operation can reduce blood cerebro⁃spinal fluid level,improve neurological function,reduce mean flow rate of the middle cerebral artery the and reduce inci⁃dence of complications for patients with severe craniocerebral injury combined with SAH.

关 键 词：腰大池持续引流 重型颅脑损伤 蛛网膜下腔出血 神经功能 

分 类 号：R651.1[医药卫生—外科学]