持续腰大池引流术引流与多次腰椎穿刺术引流治疗重型颅脑损伤合并蛛网膜下腔出血

Continuous Lumbar Cistern Drainage and Drainage with Lumbar Puncture and Drainage in the Treatment of Multiple Injury Complicated with Subarachnoid Hemorrhage and Severe Craniocerebral

目的探讨持续腰大池引流术引流与多次腰椎穿刺术引流治疗重型颅脑损伤合并蛛网膜下腔出血的效果。方法随机选取入医院治疗的重型颅脑损伤合并蛛网膜下腔出血患者70例作为研究对象,采用数字随机法将患者分为对照组和观察组,对照组行多次腰椎穿刺术引流治疗,观察组采用持续腰大池引流术引流治疗,行格拉斯哥昏迷评分（GCS）、格拉斯哥预后评分（GOS）,记录脑脊液红细胞计数低于100×10~6/L的时间,观察术后1个月内并发症发生率。结果观察组治疗后GCS为（12.52±1.51）分显著高于对照组,脑脊液红细胞〈100×10~6/L时间为（7.24±1.53）d显著短于对照组,差异有统计学意义（P〈0.05）。观察组治疗后1个月内癫痫、脑积水、脑梗死的发病率分别为0.0%、5.71%、2.86%显著低于对照组11.43%、22.86%、22.86%,差异有统计学意义（P〈0.05）。观察组良好率为57.14%明显高于对照组31.43%,死亡率为0.0%明显低于对照组14.29%,差异有统计学意义（P〈0.05）。结论持续腰大池引流术引流能够缩短引流时间,降低术后并发症发生率,可改善患者预后。

Objective To study the effect of the continuous lumbar cistern drainage and drainage with lumbar puncture and drainage in the treatment of multiple injury complicated with subarachnoid hemorrhage and severe craniocerebral.Methods Selected combined subarachnoid hemorrhage in 70 cases as the object of study into the hospital for treatment of severe craniocerebral injury,by using randomly were divided into the observation group and the control group,the control group underwent repeated lumbar puncture drainage treatment,the observation group with continuous lumbar cistern drainage drainage treatment,for Glasgow coma score（GCS）,Glasgow Outcome Scale（GOS）,recording the cerebrospinal fluid red blood cell count of less than 100×10~6/L time,observed the rate of complications within 1 month.Results In observation group after treatment,GCS（12.52±1.51）was significantly lower than that of the control group,CSF erythrocyte 100×10~6/L time was（7.24±1.53）days,which was significantly shorter than the control group,the difference was statistically significant（P〈0.05）.Observation of 1 months of epilepsy,hydrocephalus,cerebral infarction group after treatment,the incidence rates were 0%,5.71%,2.86%,which were significantly lower than the control group 11.43%,22.86%,22.86%,the differences were statistically significant（P〈0.05）.Good rate was 57.14%in observation group was significantly higher than the control group 31.43%,mortality of 0%was lower than that of the control group 14.29%,the difference was statistically significant（P〈0.05）.Conclusion Continuous lumbar cistern drainage drainage can shorten the drainage time,reduce the incidence of postoperative complications,which can improve the prognosis of the patients.