双侧脑室外引流联合腰大池引流治疗脑室铸型出血的疗效分析

Curative effect analysis of bilateral external ventricular drainage combined with lumbar cistern drainage treatment on intraventricular hemorrhage

目的分析双侧脑室外引流联合腰大池引流治疗脑室铸型出血的临床疗效。方法将76例脑室铸型出血的患者根据治疗方法分为观察组和对照组各38例,两组患者均行双侧脑室外引流术,观察组在此引流术后第2天再行腰大池引流。观察两组患者术后3、7d脑室血肿清除、脑室引流时间及脑脊液恢复正常时间,并发症发生率及患者死亡率,日常生活能力(ADL)评分。结果观察组术后3、7d脑室血肿清除率明显高于对照组(P<0.05),脑室外引流时间及脑脊液恢复正常时间比对照组明显缩短(P<0.01),肺部感染、颅内感染等并发症发生率及死亡率均比对照组明显减少(P<0.05),ADL评分明显优于对照组(P<0.05)。结论双侧脑室外引流联合腰大池引流治疗脑室铸型出血,能迅速降低颅内压,快速疏通脑脊液循环,明显提高临床治疗效果和患者的日常生活能力,具有广阔的临床应用前景。

Objective To assess the clinical effectiveness of bilateral external ventricular drainage combined with lumbar cistern drainage treatment on cerebroventricular hemorrhage casting. Methods 76 cases with intraventricular hemorrhage were divided into observation group and control group with 38 patients in each gorup. All patients underwent bilateral external ventrieular drainage. Second days after surgery, the observation group were given lumbar cisterna drainage treatment. Clearing of ventricle hematoma, the time of ventricle drainage time, the time of normal cerebrospinal fluid, complication rate, mortality and the ability of daily life （ADL） scores were observed at 3 and 7 days after treatment. Results The clearing rate of patients in observation group with 3,7d ventricle hematoma were significantly more than the control group（P 〈 0.05）; The time of ventricle drainage and time of normal cerebrospinal fluid in observation group were obviously less than those in control group（P 〈 0.01）; The incidence of complications and mortality in observation group were significantly less than those in control group（P 〈 0.05）; The ADL score in observation group was significantly better than that in control group（P 〈 0.05）. Conclusion Bilateral external ventricular drainage combined with lumbar cistern drainage treatment can rapidly reduce the intracranial pressure, fast dredge cerebrospinal fluid circulation, improve the clinical treatment effect and patient＇s daily life ability.It has the broad prospects of clinical application.