腰大池置管改良后精准控速引流在治疗蛛网膜下腔出血中的临床疗效

Modified velocity-controlled lumbar cistern drainage for subarachnoid hemorrhage

目的对腰大池引流改良后精准控速引流的临床应用效果进行分析.方法将2014年8月至2017年12月期间本院收治76例蛛网膜下腔出血作为此次研究对象,以硬币分组形式将其分为两组,各38例.对照组患者给予腰大池置管持续外引流,研究组患者给予改良式腰大池置管控速引流,对其治疗效果进行分析.结果研究组患者引流管堵管、脑积水、脑疝发生率分别为2（5.3%）、0（0.0%）、1（2.6%）低于对照组,差异均有统计学意义（均P 〈0.05）;研究组患者头痛持续时间及MCA血流流速分别为（7.7±1.3）d、（98.0±6.3）cm/s低于对照组,差异均有统计学意义（均P 〈0.05）.结论腰大池引流改良是一种安全系数高、操控简便容易的方法,改良引流后能够有效降低引流管堵管、脑积水、脑疝发生率,且能够缩短头痛持续时间,成本低,值得在各二三级医院的神经内外科推广.

Objective To study the curative effect of modifed velocity-controlled lumbar cistern drainage for subarachnoid hemorrhage. Methods 76 patients with subarachnoid hemorrhage treated at our hospital from August, 2014 to December, 2017 were selected as study objects, and randomly divided into a control group and a study group, 38 cases for each group. The control group were treated with lumbar puncture and continuous external drainage, and the study group with modifed velocity-controlled lumbar cistern drainage. The relevant clinical materials were reviewed and analyzed. Results The incidences of catheter blockage, hydrocephalus, and cerebral hernia were signifcantly lower in the study group 2（5.3%）, 0（0.0%）, 1（2.6%） than in the control group （all P 〈 0.05）. The duration of headache and the fow velocity of MCA were signifcantly lower in the study group （7.7±1.3） d, （98.0±6.3） cm/s than in the control group （both P 〈 0.05）. Conclusion Modifed velocity-controlled lumbar cistern drainage for patients of subarachnoid hemorrhage can reduce the incidences of catheter blockage, hydrocephalus and cerebral hernia and shorten headache duration. It is a safe, effective and affordable method. Therefore, it is worth being generalized.