侧脑室外引流术与腰大池持续引流术治疗脑室出血的疗效对比分析  

Comparative analysis of effects of lateral ventricular external drainage and continuous lumbar cistern drainage in ventricular hemorrhage

作　　者：张入丹[1] 蒋敏[1] 余政[1] 王剑波[1] 田劲[1] 邓超[1] 耿宝伟 吴小波[1] 张轶行[1] 廖鹏[1] ZHANG Rudan;JIANG Min;YU Zheng;WANG Jianbo;TIAN Jin;DENG Chao;GENG Baowei;WU Xiaobo;ZHANG Yixing;LIAO Peng(Department of Neurosurgery,Chongqing Municipal Fuling Central Hospital,Chongqing 408000,China)

机构地区：[1]重庆市涪陵中心医院神经外科,408000

出　　处：《重庆医学》2021年第22期3850-3852,3856,共4页Chongqing medicine

基　　金：国家重点研发计划数字诊疗装备研发重点专项(2017YFC0111900)。

摘　　要：目的对比分析侧脑室外引流术与腰大池持续引流术治疗脑室出血的效果。方法回顾性分析106例脑室出血患者临床资料,根据治疗方式分为侧脑室外引流组(67例)和腰大池引流组(39例),比较两组患者治疗效果及预后情况。结果与腰大池引流组比较,侧脑室外引流组术后3、7 d脑脊液蛋白水平均较低[(3.95±0.42)g/L vs.(6.23±0.31)g/L,t=1.698,P=0.029;(0.98±0.41)g/L vs.(3.38±0.39)g/L,t=1.985,P=0.027],术后1、3 d血肿清除率均较高(t=6.130,P=0.032;t=7.690,P=0.019)。与腰大池引流组比较,侧脑室外引流组再出血、颅内感染、脑积水、预后不良发生率更高(χ^(2)=0.013,P=0.035;χ^(2)=0.048,P=0.021;χ^(2)=0.061,P=0.017;χ^(2)=2.458,P=0.025)。结论腰大池持续引流治疗脑室出血与侧脑室外引流比较,早期血肿清除较慢,但创伤小,并发症发生率低,预后良好。Objective To comparatively analyze the effects of lateral ventricular drainage and continuous lumbar cistern drainage in the treatment of ventricular hemorrhage.Methods The clinical data of 106 patients with lateral ventricular hemorrhage were retrospectively analyzed.The patients were divided into the lateral ventricular external drainage group(n=67)and lumbar cistern drainage group(n=39).The therapeutic effects and prognosis were compared between the two groups.Results Compared with the lumbar cistern drainage group,the levels of cerebrospinal fluid protein on postoperative 3,7 d in the lateral ventricular external drainage group were lower[(3.95±0.42)g/L vs.(6.23±0.31)g/L,t=1.698,P=0.029;(0.98±0.41)g/L vs.(3.38±0.39)g/L,t=1.985,P=0.027],the hematoma clearance rates on postoperative 1,3 d were higher(t=6.130,P=0.032;t=7.690,P=0.019);compared with the lumbar cistern drainage group,the incidence rates of re-bleeding,intracranial infection,hydrocephalus and poor prognosis were higher(χ^(2)=0.013,P=0.035;χ^(2)=0.048,P=0.021;χ^(2)=0.061,P=0.017;χ^(2)=2.458,P=0.025).Conclusion Compared with ventricular external drainage,the early hematoma clearance in the lumbar cistern continuous drainage for treating ventricular hemorrhage is slower,but the trauma is small with low incidence rate of complications and good prognosis.

关 键 词：脑室出血 腰大池引流术 脑室外引流术 疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学]