腰大池持续引流治疗重型颅脑损伤并蛛网膜下腔出血的临床分析

Clinical analysis of lumber continued drainage of cerebrospinal fluid in treatment of traumatic subarachnoid hemorrhage

目的探讨腰大池持续引流治疗重型颅脑损伤并蛛网膜下腔出血的临床疗效。方法本文回顾性分析我院2013年7月～2015年6月收治的80例重型颅脑损伤后TSAH患者临床资料，根据患者术后引流术不同，将其分为观察组与对照组，每组各40例。对照组给予腰椎穿刺放液，观察组给予腰大池持续脑脊液引流术。观察两组患者蛛网膜下腔积血的清除时间，及术后6个月对两组患者进行GOS评定疗效。对比两组患者并发症发生情况，包括神经刺激症状，脑梗死，感染，脑积水，癫痫。结果观察组在术后并发症发生率明显低于对照组，差异有统计学意义（X^2=5．148，P〈0．05）。观察组患者术后积血清除时间（7．32±3．63）d，明显少于对照组（13．63±3．77）（1，存在统计学差异（P〈0．05）。术后6个月对两组患者进行COS预后评价，观察组预后结果明显好于对照组，差异显著具有统计学意义（P〈0．05）。结论腰大池持续引流治疗重型颅脑损伤并蛛网膜下腔出血，可以有效的清除蛛网膜下腔积血，降低并发症的发生率，提高患者预后生活质量，值得临床广泛应用。

Objective To investigate the clinical effect of lumber continued drainage of cerebrospinal fluid in treatment of traumatic subarachnoid hemorrhage. Methods The clinical data of 80 patients with TSAH were retrospectively analyzed,who were in our hospital from July 2013 to June 2015.The patients were divided into observation group and control group,d0 cases in each group.The control group was given lumbar puncture drainage,the observation group was givenlumber continued drainage of cerebrospinal fluid.The clearance time of subarachnoid hemorrhage was observed in two groups.After operation 6 months,the patients in the two groups were evaluated by GOS.The complications of the two groups were compared,including the symptoms of nerve stimulation,cerebral infarct ion,infection,hydrocephalus,epilepsy. Results The incidence of postoperative complications in the observation group was significantly lower than that of the control group,the difference was statistically significant （X^2=5.148,P 〈 0.05 ）. The observation group of postoperative blood collection clear time （7.32 ± 3.63）d,was significantly less than the control group （13.63 ± 3.77）d,and there was a significant difference （P 〈 0.05）.The prognosis of the observation group was significantly better than that of the control group,the difference was statistically significant （P 〈 0.05）. Conclusion Continuous lumbar cistern drainage in the treatment of severe craniocerebral injury and subarachnoid hemorrhage can effectively clear subarachnoid hemorrhage,reduce the incidence of complications,improve the prognosis of patients with quality,and is worthy of clinical aoolication.