侧脑室引流对脑出血破入脑室患者认知功能的影响及并发感染的临床研究

Effect of microinvasive ventricular drainage on cognitive function of patients with cerebral hemorrhage broken into ventricles and clinical research of concurrent infections

目的调查内科保守治疗与微创侧脑室引流对脑出血破入脑室患者认知功能改善的影响及并发感染状况,为临床医师诊断与治疗提供依据。方法选择脑出血破入脑室患者72例,随机分为对照组(内科保守组)与治疗组(微创引流组),每组分别为38例和34例,运用简易精神状态检查表(MMSE)分别在治疗前、治疗后2周和4周评价患者认知功能。结果治疗组与对照组在治疗前MMSE分值,差异无统计学意义,治疗后2周和4周MMSE分值分别为(23.58±4.03)、(23.71±3.87)分,对照组分别为(21.64±3.71)、(21.80±3.59)分,差异有统计学意义(P<0.05);34例脑出血微创侧脑室引流患者的感染部位常见于胃肠道、皮肤黏膜、口腔、呼吸道、气管切开、泌尿道等部位,其中以呼吸道感染为主,感染率为28.95%。结论微创侧脑室引流治疗对脑出血破入脑室患者的认知功能恢复更具有积极意义。

OBJECTIVE To explore the effects of the conservative treatment and the microinvasive ventricular drainage on the recovery of cognitive function of the patients with cerebral hemorrhage broken into ventricles and investigate the status of the concurrent infections so as to provide basis for the clinical diagnosis and treatment.METHODS A total of 72 patients cerebral hemorrhage broken into ventricles were selected and randomly divided into the control group（conservative treatment of internal medicine group）with 38 cases and the treatment group（microinvasive ventricular drainage group）with 34 cases,the mini mental state examination（MMSE） table was employed to evaluate the cognitive function of the patients on 2 weeks and 4 weeks before and after the treatment.RESULTS The difference in the MMSE before the treatment between the treatment group and the control group was not statistically significant.The MMSE scores of the treatment group on 2 weeks and 4 weeks after the treatment were（23.58±4.03）points and（23.71±3.87）points,respectively,the control group（21.64±3.71）points and（21.80±3.59） points,the difference was statistically significant（P 0.05）.Of the 34 patients who underwent the microinvasive ventricular drainage,the infections most frequently occurred in the gastrointestinal tract,skin and mucosa,oral cavity,respiratory tract,tracheotomy site,and the urinary tract,among which the respiratory tract was the predominant infection site,the infection rate was 28.95%.CONCLUSION Microinvasive ventricular drainage is of positive significance in the recovery of cognitive function of the patients with hemorrhage broken into ventricles.