脑室外引流术与经额锁孔脑室血肿清除术治疗脑室出血并脑室铸型的效果  

Efficacy analysis of extraventricular drainage and removal of the frontal lock ventricle hematoma in the treatment of ventricular hemorrhage with ventricular casts

作　　者：王家清 WANG Jia-qing(Department of Neurosurgery,No.970 Hospital of PLA,Yantai,Shandong 264002,China)

机构地区：[1]解放军第970医院神经外科,山东烟台264002

出　　处：《实用医药杂志》2021年第5期410-412,421,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨脑室外引流术与经额锁孔脑室血肿清除术治疗脑室出血并脑室铸型的效果。方法应用随机数字表法将2017年3月—2020年3月诊治的68例脑室出血并脑室铸型患者分为2组,A组给予经额锁孔脑室血肿清除术,B组给予脑室外引流术,对2组手术效果、炎症指标、并发症进行观察。结果A组术后残余血量低于B组,引流管留置时间短于B组,出院当日格拉斯哥预后(GOS)评分高于B组,2组比较差异有统计学意义(P<0.05);A组术前C反应蛋白、肿瘤坏死因子α(TNF-α)分别与B组比较,差异无统计学意义(P>0.05),A组术后3dCRP、TNF-α较B组明显降低;A组颅内感染、脑脊液漏发生率分别为5.88%、2.94%,较B组23.53%、17.65%低,差异有统计学意义(P<0.05)。结论经额锁孔脑室血肿清除术治疗脑室出血并脑室铸型较脑室外引流术效果更显著,能明显降低炎症反应,并发症少。Objective To investigate the effect of extraventricular drainage and transfrontal locked ventricular hematoma removal in the treatment of ventricular hemorrhage with ventricular casts.Methods 68 cases of intraventricular hemorrhage treated in our hospital from March 2017 to March 2020 were divided into two groups by random digital table method.Group A was treated with frontal lock ventricle hematoma removal and group B treated with extraventricular drainage.The surgical effect inflammatory indexs and complications in two groups were observed.Results The postoperative residual blood volume of group A was lower than that of group B,the drainage tube indwelling time was shorter than that of group B,and the Glasgow prognosis(GOS)score on the day of discharge was higher than that of group B.There was no significant difference in preoperative Creactive protein and tumor necrosis factorα(TNF-α)between group A and group B,postoperative 3dCRP and TNF-αin group A were significantly lower than those in group B(P<0.05),the incidence of intracranial infection and cerebrospinal fluid leakage in group A were 5.88%and 2.94%,which were lower than those in group B(23.53%and 17.65%).Conclusion Transfrontal keyhole removal of ventricular hematoma is more effective than ventricular drainage in the treatment of ventricular hemorrhage with ventricular casting,which can significantly reduce the inflammatory and have fewer complications.

关 键 词：脑室外引流术 经额锁孔 脑室血肿清除术 脑室出血 脑室铸型 

分 类 号：R743.34[医药卫生—神经病学与精神病学]