腰大池持续引流在高血压脑出血小骨窗开颅术后的应用

Application of Lumber continued drainage of cerebrospinal fluid after Key-hole approach operation on hyperteusive intracerebral hemorrhage.

目的评估小骨窗开颅血肿清除术后进行腰大池持续引流与标准大骨瓣开颅血肿清除对高血压脑出血患者预后的影响。方法对38例高血压脑出血患者采用小骨窗开颅血肿清除术后进行腰大池持续引流治疗，于术后1、6个月分别行GCS、GOS、Barthel指数、语言障碍程度及运动功能障碍程度评分，并与标准大骨瓣开颅血肿清除术治疗的34例患者进行比较。结果实验组与对照组术前、术后1周GCS评分分别为6．8±2．1与6．6±2．3，10．5±2．5与8．7±2．2；术后1、6个月GOS评分分别为3．4±0．3与2．8±0．2，4．1±0．6与3．2±0．4；术后6个月Barthel指数、语言障碍程度及运动功能障碍程度评分分别为63．15±11．64与51．76±12．81，1．7±0．3与2．3±0．2，2．0±0．3与2．6±0．4；2组比较，差异均有统计学意义（P〈0．05或P〈0．01）。结论小骨窗开颅血肿清除术后进行腰大池持续引流治疗高血压脑出血的患者与对照组相比，神经功能恢复速度较快、恢复程度较高，有利于提高患者的生存质量。

Objective To evaluate the therapeutic effects of Lumber continued drainage of eerebrospinal fluid after Key-hole approach operation and eraniotomie hematoma elimination on the prognosis of hypertensive intraeerebral hemorrhage patients. Methods Lumber continued drainage of cerebrospinal fluid after Key-hole approach operation was conducted on 38 hypertensive intraeerebral hemorrhage patients. At the 1st month and 6th month after operation, Glasgow coma scale （ GCS ）, Glasgow outcome scale （ GOS ）, Barthel index, language barrier degree evaluation and sports function barrier degree evaluation were measured. The therapeutic effects were observed and compared with 34 patients who were operated by craniotomic hematoma elimination. Results GCS was 6.8 ±2.1,6.6 ±2.3 before operation and 10.5 ±2.5,8.7 ±2.2 one week after operation in experimental group and control group respectively ; GOS was 3.4 ± 0.3,2.8 ± 0.2 one month after operation and 4.1 ± 0.6,3.2 ± 0.4 six month after operation in experimental group and control group respectively; Bartherl index, language barrier degree and sports function barrier degree were 63.15 ±11.64,51.76 ±12.81 and 1.7± 0.3,2.3 ± 0.2,2.0 ± 0.3, and 2.6 ±0.4 （ P 〈 0.05 or P 〈 0.01 ）. Conclusion Lumber continued drainage of cerebrospinal fluid after Key-hole approach operation offers greater help in improving the patients＇ quality of existence, by which the neurological function recovers faster and the patients recover well.