去骨瓣减压联合腰大池引流术治疗重型颅脑损伤伴蛛网膜下腔出血的效果  

Effect of Decompressive Craniotomy Combined with Lumbar Drainage in the Treatment of Severe Craniocerebral Injury with Subarachnoid Hemorrhage

作　　者：李坤业 杨生琴 周桂兰 Li Kunye;Yang Shengqin;Zhou Guilan(Department of Brain Surgery,Xining First People's Hospital,Xining 810000,Qinghai Province,China)

机构地区：[1]西宁市第一人民医院脑外科,青海西宁810000

出　　处：《中外医药研究》2024年第18期30-32,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探讨去骨瓣减压联合腰大池引流术治疗重型颅脑损伤伴蛛网膜下腔出血的效果。方法:选取2021年1月—2023年1月西宁市第一人民医院收治的重型颅脑损伤伴蛛网膜下腔出血患者80例作为研究对象,随机分为对照组(行去骨瓣减压联合腰椎穿刺引流)与观察组(行去骨瓣减压联合腰大池引流术),各40例。比较两组颅内压、脑脊液SP100、脑脊液红细胞数量、脑脊液转清时间、并发症发生率及预后效果。结果:治疗后,两组颅内压、脑脊液SP100、脑脊液红细胞数量降低,且观察组低于对照组,差异有统计学意义(P<0.05);观察组脑脊液转清时间短于对照组,差异有统计学意义(P<0.001)。观察组并发症发生率低于对照组,差异有统计学意义(P=0.028)。观察组预后良好率高于对照组,差异有统计学意义(P=0.036)。结论:应用去骨瓣减压联合腰大池引流术治疗重型颅脑损伤伴蛛网膜下腔出血患者,可降低颅内压及脑脊液SP100、红细胞数量,缩短脑脊液转清时间,降低并发症发生率,预后效果显著。Objective:To investigate the effect of decompressive craniotomy combined with lumbar drainage in the treatment of severe craniocerebral injury with subarachnoid hemorrhage.Methods:A total of eighty patients with severe craniocerebral injury accompanied by subarachnoid hemorrhage admitted to Xining First People's Hospital from January 2021 to January 2023 were selected as the study objects,and were randomly divided into the control group(receiving decompressive craniotomy combined with lumbar puncture drainage)and the observation group(receiving decompressive craniotomy combined with lumbar cistern drainage),with forty cases in each group.The intracranial pressure,cerebrospinal fluid SP100,the number of red blood cells in cerebrospinal fluid,the time of cerebrospinal fluid clearance,the incidence of complications and the prognosis were compared between the two groups.Results:After treatment,the intracranial pressure,cerebrospinal fluid SP100 and the number of cerebrospinal fluid red blood cells in the two groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05);the clearance time of cerebrospinal fluid in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.001).The complication rate of the observation group was lower than that of the control group,and the difference was statistically significant(P=0.028).The good prognosis rate of the observation group was higher than that of the control group,and the difference was statistically significant(P=0.036).Conclusion:The application of craniotomy decompression combined with lumbar cisterna drainage in the treatment of severe craniocerebral injury with subarachnoid hemorrhage can reduce intracranial pressure,cerebrospinal fluid SP100 and red blood cell number,shorten the time of cerebrospinal fluid clearing,reduce the incidence of complications,and have a significant prognostic effect.

关 键 词：去骨瓣减压 腰大池引流术 重型颅脑损伤 蛛网膜下腔出血 

分 类 号：R651.15[医药卫生—外科学]