腰大池引流治疗开颅术后顽固性脑膨出的临床研究

Clinical Study of Treatment of Refractory Brain Swelling after Craniotomy with Lumbar Drainage

目的探讨腰大池引流对开颅术后顽固性脑膨出的临床效果。方法方便选取2014年1月—2018年5月该院神经外科80例开颅术后顽固性脑膨出患者为研究对象,依据治疗方法分为实验组(腰大池置管引流:40例)和对照组(间断腰穿排放脑脊液:40例),对比观察两组疝出脑组织回纳时间,评价两组神经功能改善情况,统计脑膨出复发率。结果实验组脑组织回纳时间(5.4±1.6)d短于对照组(8.9±2.2)d,术后3个月ADL评分(20.8±3.7)分低于对照组(24.6±5.4)分,差异有统计学意义(t=4.581、4.093,P<0.05)。实验组脑膨出复发(2.5%)与对照组(5.0%)比较差异无统计学意义(χ~2=1.750,P>0.05)。结论腰大池引流治疗开颅术后顽固性脑膨出起效迅速、效果确切,对改善患者预后、促进神经功能恢复具有积极作用。

Objective To investigate the clinical effect of lumbar drainage on refractory brain swelling after craniotomy. Methods From January 2014 to May 2018, 80 patients with refractory brain swelling after craniotomy in the hospital were convenient selected as experimental subjects. According to the treatment method, they were divided into experimental group （waist large tube drainage： 40 eases） and control group （intermittent cerebrospinal fluid discharge： 40 eases）, the two groups of brain tissue return time were compared, the neurological function of the two groups was evaluated, and the recurrence rate of brain swelling was counted. Results The brain tissue return time （5.4±1.6）d in the experimental group was shorter than that in the control group （8.9±2.2）d. The ADL score （20.8±3.7）points in the 3 months after operation was lower than that in the control group （24.6±5.4）points, with statistically significant difference（t=4.581,4.093, P〈0.05）. There was no significant difference in recurrence （2.5%） between the experimental group and the control group （5.0%） （X^2=1.750, P〉0.05）. Conclusion The treatment of refractory brain swelling after eraniotomy for the treatment of eraniotomy is rapid and effective, which has a positive effect on improving the prognosis of patients and promoting the recovery of neurological function.