原位骨屑回植预防脑室外引流术后颅内感染的临床效果

Clinical effect of in situ bone chip replantation in the prevention of intracranial infection after external ventricular drainage

目的:探讨原位骨屑回植术预防脑室外引流术后颅内感染的临床效果。方法:选取我科行脑室外引流术的156例患者,通过随机配对分为2组,回植组(研究组81例)和传统未回植组(对照组75例),研究组在侧脑室穿刺成功后,将收集骨屑均匀平铺在引流管和骨孔间隙,对照组术中在穿刺成功后,用明胶海绵放置在引流管和骨孔间隙,比较2组患者出现脑脊液漏、颅内感染等并发症的发生率。结果:研究组颅内感染(5例)与对照组(13例)的发生率比较差异有统计学意义(P<0.05);研究组脑脊液漏(2例)与对照组(8例)的发生率比较差异有统计学意义(P<0.05);研究组引流管放置时间≥10d的患者比例(占42%)与对照组(占24%)比较差异有统计学意义(P<0.05)。结论:原位骨屑回植在预防脑室外引流术后颅内感染效果良好。

Objective： To investigate the clinical effect of in situ bone chip replantation in the prevention of intracranial infection after external ventricular drainage. Methods： A total of 156 cases in our department for external ventricular drainage in patients was randomly divided into 2 groups, replantation group （study group, 81 cases） and conventional replantation group （control group, 75 cases）. In the study group of lateral ventricle puncture after the success of collected bone chips evenly in the drainage tube and the bone hole clearance in con- trol group during the operation after successful puncture with gelatin sponge placed in the drainage tube and the bone hole clearance, the incidence of 2 groups of patients with cerebrospinal fluid leakage, intracranial infection and other complications were compared. Results： The incidence ratio of the research group of intracranial infection （5 cases） and control group （13 cases） was statistically significant （P〈0.05）; the incidence rate ratio difference cerebrospinal fluid leakage in study group （2 cases） and control group （8 cases） was statistically significant （P〈0.05）; the placed time of the study group was more than 10 d （42%） and control group （24%） the number of cases, the difference was statistically significant （P〈0.05）. Conclusion： In situ bone chip replantation is effective in preventing intracranial infection after external ventricular drainage.