脑室镜清除脓苔及术后脑室灌洗、引流在脑室感染中的应用  

Application of Ventriculoscopy to Remove Pus Moss,Lavage and Drainage of Ventricle After Operation in Ventricular Infection

作　　者：郑刚[1] 郭旭 管玉华[1] 姜莱[1] 周健[1] 陈少军[1] ZHENG Gang;GUO Xu;GUAN Yu-hua;JIANG Lai;ZHOU Jian;CHEN Shao-jun(Department of Neurosurgery,People's Hospital of Three Gorges University,Yichang 443000,Hubei,China)

机构地区：[1]三峡大学人民医院神经外科,湖北宜昌443000

出　　处：《医学信息》2021年第18期119-121,125,共4页Journal of Medical Information

摘　　要：目的探讨脑室镜清除脑室内脓苔及术后脑室灌洗、持续引流在脑室感染中的疗效。方法选取2016年1月-2019年12月三峡大学人民医院收治的脑室感染患者60例,按照不同手术方式分为脑室镜组和单纯脑室外引流组,各30例。单纯脑室外引流组采用单纯脑室外引流治疗方案,脑室镜组采用脑室镜下清除脑室内脓苔及术后持续脑室灌洗、引流治疗方案,比较两组治疗效果、临床指标(退热时间、脑室外引流时间、住院费用、住院时间)、脑脊液及血糖、血WBC水平、感染相关细胞因子水平(C反应蛋白、降钙素原、一氧化氮)。结果脑室镜组治疗有效率为86.66%,高于单纯脑室外引流组的50.00%,差异有统计学意义(P<0.05);脑室镜组退热时间、脑室外引流时间、住院费用、住院时间均优于单纯脑室外引流组,差异有统计学意义(P<0.05);脑室镜组脑脊液乳酸、血糖水平、脑脊液WBC、血WBC低于单纯脑室外引流组,脑脊液糖水平高于单纯脑室外引流组,差异有统计学意义(P<0.05);脑室镜组脑脊液和血清C反应蛋白、降钙素原、一氧化氮均低于单纯脑室外引流组,差异有统计学意义(P<0.05)。结论脑室镜清除脓苔及术后脑室灌洗、引流可缩短脑室感染治疗疗程,减少脑室外引流时间,节约治疗费用,缩短住院天数,提高脑室感染的治愈率。Objective To investigate the effect of ventriculoscopy to remove pus coating in the ventricle,lavage and continuous drainage of the ventricle after operation in the treatment of ventricular infection.Methods A total of 60 patients with ventricle infection admitted to the First Hospital of YC from January 2016 to December 2019 were selected.According to different surgical methods,they were divided into ventriculoscopy group and ventricular drainage group alone,with 30 cases in each.The simple ventricular drainage group was treated with a simple ventricular drainage treatment plan,and the ventriculoscopy group was treated with ventricular endoscopy to remove ventricular pus moss and continuous ventricular lavage and drainage treatment plans.The treatment effects and clinical indicators(antipyretic time,extraventricular drainage time,hospitalization expenses,hospitalization time),cerebrospinal fluid and blood sugar,blood WBC level,infection-related cytokine levels(C-reactive protein,procalcitonin,nitric oxide).Results The effective rate of treatment in the ventriculoscopy group was 86.66%,which was higher than the 50.00%in the ventricular drainage group alone,the difference was statistically significant(P<0.05);Ventroscope group's antipyretic time,ventricular drainage time,hospitalization cost,and hospitalization time were better than those of simple ventricular drainage group,the difference was statistically significant(P<0.05);The cerebrospinal fluid lactic acid,blood sugar level,cerebrospinal fluid WBC,and blood WBC in the ventriculoscopy group were lower than those in the ventricular drainage group alone,and the cerebrospinal fluid glucose level was higher than that in the ventricular drainage group alone,the difference was statistically significant(P<0.05);The cerebrospinal fluid and serum C-reactive protein,procalcitonin,and nitric oxide in the ventriculoscopy group were lower than those in the simple ventricular drainage group,the difference was statistically significant(P<0.05).Conclusion Ventroscope removal

关 键 词：脑室镜 脑室灌洗 脑室外引流 脑室感染 

分 类 号：R651.1[医药卫生—外科学]