LD治疗开颅术后脑脊液切口漏合并颅内感染的作用分析  

Effect Analysis of LD in the Treatment of Cerebrospinal Fluid Incision Leakage Combined With Intracranial Infection After Craniotomy

作　　者：王永贵 WANG Yonggui(The First Department of Surgery,Dezhou Third People’s Hospital,Dezhou Shandong 253500,China)

机构地区：[1]德州市第三人民医院外一科,山东德州253500

出　　处：《中国卫生标准管理》2021年第15期51-54,共4页China Health Standard Management

摘　　要：目的分析腰大池置管引流术(lumbar cistern drainage,LD)治疗开颅术后脑脊液切口漏+颅内感染的效果。方法研究时间为2018年10月—2020年8月,共计开颅术后并发脑脊液切口漏+颅内感染患者97例。以随机法为基准,A组纳入49例,予以LD+常规化治疗;B组纳入48例,予以单纯性常规治疗。对比治疗作用。结果A组统计总有效率97.96%,高于B组的83.33%(χ^(2)=6.162,P=0.013)。治疗前,对比两组的实验室指标水平差异无统计学意义(P>0.05)。治疗2周后,A组的白细胞计数(white blood cell count,WBC)为(7.25±1.13)×10^(9)/L,体温(temperature,T)为(36.12±1.05)℃,C反应蛋白(C-reactive protein,CRP)为(10.05±1.25)mg/L,血沉(erythrocyte sedimentation rate,ESR)为(17.26±2.04)mm/h,指标水平均低于B组(P<0.05)。A组出现1例引流不畅,1例引流管渗液,无全身感染与颅内出血症状,统计并发症几率4.08%,低于B组的18.75%(χ^(2)=5.189,P=0.023)。结论为开颅术后并发脑脊液切口漏+颅内感染患者实行LD治疗能够改善疗效,且能优化实验室指标,尽量减少相关并发症。Objective To analyze the effect of lumbar cistern drainage(LD)in the treatment of cerebrospinal fluid incision leakage and intracranial infection after craniotomy.Methods From October 2018 to August 2020,97 patients with cerebrospinal fluid incision leakage and intracranial infection after craniotomy were enrolled.According to the random method,49 cases in group A were treated with LD+routine therapy,while 48 cases in group B were treated with simple routine therapy.The therapeutic effect was compared.Results The statistical total effective rate of group A was 97.96%,which was higher than 83.33%of group B(χ^(2)=6.162,P=0.133).B efore treatment,no statistically significant difference w a s found between the laboratory index levels of the two groups(P>0.05).After 2 weeks of treatment,the white blood cell count(WBC)of group A was(7.25±1.13)×10^(9)/L,body temperature(T)was(36.12±1.05)℃,and C-reactive protein(CRP)was(10.05±1.25)mg/L,erythrocyte sedimentation rate(ESR)was(17.26±2.04)mm/h and the index level was lower than that of group B(P<0.05).There was 1 case of poor drainage and 1 case of drainage tube leakage in group A.There were no symptoms of systemic infection and intracranial hemorrhage.The statistical complication rate was 4.08%,which was lower than 18.75%of group B(χ^(2)=5.189,P=0.023).Conclusion Implementing LD treatment for patients with cerebrospinal fluid incision leakage+intracranial infection after craniotomy can improve the curative effect,optimize laboratory indicators,and minimize related complications.

关 键 词：腰大池置管引流 开颅术 脑脊液切口漏 颅内感染 疗效 并发症 

分 类 号：R749[医药卫生—神经病学与精神病学]