长程、长时间持续脑室外引流术治疗脑室出血伴脑积水的疗效  

Clinical efficacy of long-tunneled and prolonged external ventricular drainage for patients with intraventricular hemorrhage associated with hydrocephalus

作　　者：张圣坤 唐忠[1] 陈启富[1] 张铭芙 陈思 董白晶 初明 ZHANG Sheng-kun;TANG Zhong;CHEN Qi-fu;ZHANG Ming-fu;CHEN Si;DONG Bai-jing;CHU Ming(Department of Neurosurgery,Shenzhen Third People's Hospital,Shenzhen 518000,China)

机构地区：[1]深圳市第三人民医院神经外科,广东518000

出　　处：《中国临床神经外科杂志》2024年第4期209-213,共5页Chinese Journal of Clinical Neurosurgery

基　　金：深圳大学高水平临床专项-深圳市神经外科专科培训试点基地提升项目(LCXKB202415);深圳市高水平医院建设专项。

摘　　要：目的探讨长程、长时间脑室外引流术治疗脑室出血伴脑积水的临床疗效。方法回顾性分析2019年10月至2022年12月应用脑室外引流术治疗的43例脑室出血伴脑积水的临床资料,其中26例采用传统脑室外引流术治疗(传统组),17例采用长程、长时间脑室外引流术治疗(长程长时间组)。结果传统组引流管放置时间7~12 d,平均(9.76±1.14)d;长程长时间组引流管放置时间13~43 d,平均(16.17±5.29)d。长程长时间组住院时间[(18.70±6.99)d]较传统组[(15.53±3.16)d]有所增加,但两组无统计学差异(P=0.101)。长程长时间组二次脑室置管率(0%)、脑脊液漏发生率(0%)、颅内感染发生率(0%)较传统组(分别为30.77%、30.77%、26.92%)均明显降低(P<0.05)。术后3个月,长程长时间组预后良好率(100.00%;mRS评分0~2分)与传统组(96.15%)无统计学差异(P=0.605)。结论长程、长时间脑室外引流术治疗脑室出血伴脑积水,虽然延长脑室引流管留置的时间,但是没有明显增加住院时间,而且明显降低二次脑室置管率、脑脊液漏和颅内感染发生率。Objective To explore the clinical efficacy of long-tunneled and prolonged external ventricular drainage(EVD)for patients with intraventricular hemorrhage(IVH)associated with hydrocephalus.Methods A retrospective analysis was conducted on the clinical data of 43 patients with IVH associated with hydrocephalus who underwent EVD between October 2019 and December 2022.Among them,26 patients were treated with traditional EVD(traditional group),and 17 patients received long-tunneled and prolonged EVD(long-tunneled and prolonged group).Results The mean duration of tube placement was significantly longer in the long-tunneled and prolonged group compared to the traditional group(16.17±5.29 days vs.9.76±1.14 days).Although the average hospital stay was slightly prolonged in the long-tunneled and prolonged group(18.70±6.99 days vs.15.53±3.16 days),there was no statistically significant difference between both groups(P=0.101).Notably,the rates of secondary ventricular catheter placement(0%vs.30.77%),cerebrospinal fluid leakage(0%vs.30.77%%),and intracranial infection(0%vs.26.92%)were markedly lower in the long-tunneled and prolonged group compared to the traditional group(P<0.05).At three months post-EVD,the good prognosis rate(100%;mRS score of 0~2)in the long-tunneled and prolonged group did not significantly differ from the traditional group(96.15%;P=0.605).Conclusions Longtunneled and prolonged EVD is effective for patients with IVH accompanied by hydrocephalus;although it prolongs EVD tube placement duration,it dose not significantly increase hospital stay.It also reduces secondary ventricular catheter placement rate as well as rates of cerebrospinal fluid leakage and intracranial infection.

关 键 词：脑室出血 脑积水 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] R651.12[医药卫生—临床医学]