脑池造瘘术治疗颅内血肿合并蛛网膜下腔出血的临床疗效  

Clinical efficacy of cisternostomy in the treatment of intracranial hematoma complicated with subarachnoid hemorrhage

作　　者：曾晓华[1] 杨艳华 熊叶[1] 揭南辉[1] 聂艳良[1] 钟富军[1] ZENG Xiaohua;YANG Yanhua;XIONG Ye;JIE Nanhui;NIE Yanliang;ZHONG Fujun(Department of Neurosurgery,Fengcheng People's Hospital,Yichun,Jiangxi,331100,China)

机构地区：[1]丰城市人民医院神经外科,江西宜春331100

出　　处：《当代医学》2023年第20期164-167,共4页Contemporary Medicine

摘　　要：目的探讨脑池造瘘术治疗颅内血肿合并蛛网膜下腔出血的效果。方法选取2019年1月至2020年12月本院收治的57例颅内血肿合并蛛网膜下腔出血患者作为研究对象,随机分为实验组(n=27)与对照组(n=30)。对照组行颅内血肿清除术,实验组在对照组基础上行脑池造瘘术,比较两组手术前后颅内压、格拉斯哥昏迷评分(GCS)评分和机械通气时间、ICU入住时间、脱水药用量、并发症发生率及术后6个月病死率。结果两组颅内压及GCS评分组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:两组术后各时点颅内压均低于术前(P<0.05),而术后2、3d均高于术后1d,且术后3d高于术后2d,差异有统计学意义(P<0.05);两组术后各时点GCS评分均高于前一时间点,差异有统计学意义(P<0.05)。组间比较:术前,两组颅内压及GCS评分比较差异无统计学意义;实验组术后各时点颅内压均低于对照组,GCS评分均高于对照组,差异有统计学意义(P<0.05)。实验组术后机械通气时间、ICU入住时间均短于对照组,脱水药用量少于对照组,差异有统计学意义(P<0.05)。两组颅内感染、脑积水发生率及6个月病死率比较差异均无统计学意义。结论脑池造瘘术治疗颅内血肿合并蛛网膜下腔出血患者效果确切,可控制引流脑脊液,有效降低颅内压,缩短ICU入住时间,减少脱水用药量,降低并发症发生率及病死率,值得临床推广应用。Objective To investigate the clinical efficacy of cisternostomy in the treatment of intracranial hematoma complicated with subarach-noid hemorrhage.Methods 57 patients with intracranial hematoma complicated with subarachnoid hemorrhage admitted to our hospital from Janu-ary 2019 to December 2020 were selected as the study subjects,and they were randomly divided into the experimental group(n=27)and the control group(n=30).The control group underwent intracranial hematoma removal,and the experimental group underwent cisternostomy on the basis of the control group,the intracranial pressure,Glasgow coma score(GCS)score before and after surgery,mechanical ventilation time,ICU stay time,dehy-drating drug dosage,complication rate and 6-month postoperative mortality were compared between the two groups.Results There were significant differences in intracranial pressure and GCS scores between the two groups of group,time points and interaction(P<0.05).Comparison within groups:the intracranial pressure of the two groups at each time points after surgery were lower than those before surgery,but 2 and 3 d after surgery were higher than 1 d after surgery,and 3 d after surgery was higher than 2 d after surgery,the differences were statistically significant(P<0.05);the GCS score of the two groups at each time point after surgery were higher than those at the previous time point,and the differences were statistically significant(P<0.05).Comparison between groups:before surgery,there were no significant differences in intracranial pressure and GCS scores be-tween the two groups;the intracranial pressure in the experimental group at each time point after surgery were lower than those in the control group,and the GCS score at each time point after surgery were higher than those in the control group,and the differences were statistically significant(P<0.05).The mechanical ventilation time,ICU stay time in the experimental group were shorter than those in the control group,and dehydrating drug dosage in the experimental group were le

关 键 词：脑池造瘘术 颅内血肿 蛛网膜下腔出血 

分 类 号：R651.1[医药卫生—外科学]