脑池造瘘术及脑脊液引流治疗重型颅脑损伤的临床疗效  

Clinical efficacy of cisternostomy and cerebrospinal fluid drainage in the treatment of severe craniocerebral injury

作　　者：王余军 陈新成 孟伟 吴自成 WANG Yujun;CHEN Xincheng;MENGWei;WU Zicheng(Department of Neurosurgery,Xinyi People's Hospital,Xinyi,Jiangsu,221400,China)

机构地区：[1]新沂市人民医院神经外科,江苏新沂221400

出　　处：《当代医学》2022年第25期105-107,共3页Contemporary Medicine

摘　　要：目的探讨脑池造瘘术及脑脊液引流治疗重型颅脑损伤的临床疗效。方法选取2018年5月至2021年5月新沂市人民医院神经外科收治的47例重型颅脑损伤患者作为研究对象,根据随机信封法分为常规组(n=23)和实验组(n=24)。常规组行常规开颅血肿清除和去骨瓣减压术治疗,实验组在对照组基础上行脑池造瘘术及脑脊液引流治疗,比较两组临床疗效、重症监护室(ICU)入住时间、住院治疗时间、术后不同时间颅内压、格拉斯哥预后量表(GOS)评分及不良反应发生情况。结果实验组治疗总有效率为95.83%,高于常规组的69.57%(P<0.05)。实验组ICU入住时间、住院治疗时间均短于常规组(P<0.05)。术后1、6、12 h,实验组颅内压均低于常规组(P<0.05)。实验组GOS评分高于常规组(P<0.05)。实验组不良反应发生率为4.17%,低于常规组的34.78%(P<0.05)。结论脑池造瘘术及脑脊液引流治疗重型颅脑损伤疗效显著,可有效降低患者颅内压,促进患者康复,减少不良反应的发生,利于改善预后,值得临床推广应用。Objective To explore the clinical efficacy of cisternostomy and cerebrospinal fluid drainage in the treatment of severe craniocerebral injury.Methods 47 patients with severe craniocerebral injury treated in the department of Neurosurgery of Xinyi People's Hospital from May 2018 to May 2021 were selected as the research subjects,and they were divided into routine group(n=23)and experimental group(n=24)according to the random envelope method.The routine group was treated with routine craniotomy for hematoma removal and decompression craniectomy,while the experimental group was treated with cisternostomy and cerebrospinal fluid drainage on the basis of the control group.The clinical efficacy,intensive care unit(ICU)admission time,hospitalization time,intracranial pressure at different times after operation,Glasgow outcome scale(GOS)score and adverse reactions were compared between the two groups.Results The total effective rate of the experimental group was 95.83%,which was higher than 69.57%of the routine group(P<0.05).The ICU admission time and hospitalization time in the experimental group were shorter than those in the routine group(P<0.05).At 1,6,and 12 h after operation,the intracranial pressure in the experimental group was lower than that in the routine group(P<0.05).The GOS score in the experimental group was higher than that in the routine group(P<0.05).The incidence of adverse reactions in the experimental group was 4.17%,which was lower than 34.78%in the routine group(P<0.05).Conclusion Cisternostomy and cerebrospinal fluid drainage have significant curative effects in the treatment of severe craniocerebral injury,which can effectively reduce the intracranial pressure,promote patient recovery,reduce the occurrence of adverse reactions,help improve prognosis,which is worthy of clinical application.

关 键 词：脑池造瘘术 脑脊液引流 重型颅脑损伤 

分 类 号：R651.15[医药卫生—外科学]