饮水量对慢性硬膜下血肿钻孔引流术后脑复张的影响

Effect of volume of drunk water on brain recruitment after chronic subdural hematoma drainage

目的探讨饮水量对慢性硬膜下血肿钻孔引流术后脑复张的影响。方法 2016年1月至2017年12月择期行钻孔引流术治疗慢性硬膜下血肿156例,按术后饮水量分为大量饮水组(饮水量≥2 000 ml/d,52例)、适量饮水组(饮水量1 000~2000ml/d,52例)和少量饮水组(饮水量≤1 000 ml/d,52例)。术前、术后14 d测量脑灌注压,行头颅CT评价脑复张。结果随着饮水量的增加,脑灌注压明显上升(P<0.05),而脑复张不全发生率明显降低(P<0.05)。3组术后血肿复发率无统计学差异(P>0.05)。结论慢性硬膜下血肿钻孔引流术术后饮水量≥2 000 ml/d,可提高脑灌注压,降低脑复张不全发生率。

Objective To investigate the effect of the volume of drunk water on brain recruitment after the drainage of the chronic subdural hematoma （CSDH）. Methods The drainage of the hematomas was performed in 156 patients with CSDH from January, 2016 to December, 2017. The 156 patients were divided into 3 groups of 52 patients each, i.e. group A in which each patient drank more than 2 000 ml of water every day, group B in which 1000-2000 ml and group C in which less than 1000 ml. The cerebral perfusion pressure （CPP） were determined and the cerebral re-expansion levels were assessed by head CT before and 14 days after the drainage. Results CPP was significantly higher after the drainage than that before the drainage in all the groups （P〈0.05）. After the drainage, CPP was significantly higher in group A than that in group B （P〈0.05）, which was significantly higher than that in group C （P〈0.05）. The rates of good cerebral recruitment were significantly higher in groups A and B respectively than that in group C （P〈0.05）, but there was insignificant difference in the rate of good cerebral recruitment between groups A and B 14 days after the drainage （P〉0.05）. Conclusions The CPP and rate of good cerebral recruitment can be enhanced by the drinking of more than 2000 ml/day of water in the patients with CSDH after the drainage of the hematomas.