腰大池持续引流用于开颅术后60例临床分析

Lumbar cistern continuous drainage for clinical analysis of 60 cases of craniotomy

目的探讨开颅术后辅助腰大池持续引流治疗重型颅脑损伤的机制和效果。方法重型颅脑损伤开颅术后患者60例,随机分为治疗组和对照组。治疗组患者于开颅术后第2天行腰大池持续引流,对照组患者于开颅术后第2天行腰穿放液。结果治疗组和对照组患者脑脊液中红细胞(RBC)<100×106/L的时间分别为伤后(5.0±2.3)d和(7.1±3.5)d(P<0.01);两组脑脊液中蛋白(TP)<0.8g/L的时间分别为伤后(8.0±3.6)d和(11.2±4.4)d(P<0.01);治疗组伤后1周内平均颅内压、甘露醇用量显著低于对照组;脑积水及脑梗死发生率显著低于对照组;重残率、病死率显著低于对照组。结论腰大池持续引流可快速廓清患者的血性脑脊液,辅助降低颅内压,减少甘露醇用量,减少并发症,显著降低重残率及病死率,改善预后。

Objective To explore the craniotomy aided lumbar continuous drainage treatment of severe head injury mechanisms and effects.Methods Of severe traumatic brain injury after craniotomy,60 patients randomized into treatment group and control group.Treatment of patients in the craniotomy 2 Alfa lumbar continuous drainage,control group patients to the craniotomy 2 Alfa lumbar puncture on the liquid.Results Of the treatment group and control group patients in cerebrospinal fluid in the red blood cell（RBC） 100×106/L time are wound（5.0 ± 2.3） days and（7.1 ± 3.5） days（P0.01）;two sets of cerebrospinal fluid protein（TP） 0.8g/L time are wound（8.0 ± 3.6） days and（11.2 ± 4.4） days（P0.01）;treatment group after 1 week average intracranial pressure,mannitol dosage is significantly less than the control group;hydrocephalus and cerebral infarction incidence is significantly less than the control group;heavy residual rate,case fatality rate significantly lower than the control group.Conclusion Of the lumbar continuous drainage can be rapid clearance of cerebrospinal fluid in patients with ischemic,auxiliary reduce intracranial pressure,reduce consumption,reduce the complications of mannitol,significantly reducing the heavy residual rate and case fatality rate,improve prognosis.