脑室-腰大池序贯引流治疗重度脑室出血后继发引流依赖性脑积水的原因分析  

Causes of secondary drainage dependent hydrocephalus after severe intraventricular hemorrhage treated with sequential drainage of ventricles and lumbar cistern

作　　者：张晋宁[1] ZHANG Jinning(Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院,福建泉州362000

出　　处：《中华神经外科疾病研究杂志》2024年第5期35-38,共4页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探究对重度脑室出血患者行脑室-腰大池序贯引流后发生脑积水的影响因素。方法选择2017年1月至2022年1月泉州市第一医院神经外科收治的重度脑室出血患者99例。根据是否继发脑积水分为实验组(n=33)和对照组(n=66),比较分析两组患者的临床数据。结果实验组患者Graeb评分更高,脑脊液引流速度≤8-10 ml/h的比例更高,引流时程≤7 d的比例更高,上述差异均具有统计学意义(P<0.05),实验组患者治疗有效率为72.73%,显著低于对照组(88.76%),差异有统计学意义(P<0.05)。结论脑室-腰大池序贯引流治疗重度脑室出血是安全有效的。高Graeb评分、脑脊液引流速度慢(≤8-10 ml/h)、引流时程短(≤7 d)等均是脑室出血引流术后继发引流依赖性脑积水的独立危险因素,针对性地减少上述危险因素,可减少脑积水的发生率,改善预后。Objective To explore the influential factors of hydrocephalus after sequential external ventricular and lumbar cistern drainage in patients with severe intraventricular hemorrhage.Methods A total of 99 patients with severe intraventricular hemorrhage admitted to the Department of Neurosurgery of Quanzhou First Hospital Affiliated to Fujian Medical University from January 2017 to January 2022 were divided into experimental group(n=33)and control group(n=66)according to their secondary hydrocephalus status.A comparative analysis of the clinical data of the two groups was conducted.Results In the experimental group,patients with higher Graeb score,cerebrospinal fluid drainage speed≤8-10 ml/h and total drainage duration≤7 days,had a higher proportion of hydrocephalus.There was a statistically significant difference(P<0.05).The effective rate of the experimental group was 72.73%,which was significantly lower than that of the control group(88.76%).The difference was statistically significant between the two groups(P<0.05).Conclusions The sequential external ventricular and lumbar cistern drainage are safe and effective in the treatment of severe intraventricular hemorrhage.Higher Graeb score,slower speed of cerebrospinal fluid drainage(8-10 ml/h or less)and less in duration of drainage(7 days or less)were independent risk factors for drainage dependent hydrocephalus secondary to drainage for intraventricular hemorrhage.The incidence of hydrocephalus can be reduced and the prognosis may be improved with the corresponding control of the above risk factors.

关 键 词：脑室引流 腰大池引流 脑室出血 脑积水 

分 类 号：R743.34[医药卫生—神经病学与精神病学]