软通道钻孔引流术联合腰大池置管在非脑疝高血压性脑出血合并蛛网膜下腔出血治疗中的临床效果

Clinical Effect of Flexible Channel Drilling and Drainage Combined with Lumbar Cistern Catheter in the Treatment of Non-Herniated Hypertensive Intracerebral Hemorrhage Combined with Subarachnoid Hemorrhage

目的:分析软通道钻孔引流术联合腰大池置管治疗非脑疝高血压性脑出血合并蛛网膜下腔出血的临床效果。方法:选取2014年1月-2022年7月山东省菏泽市中医医院神经外科收治的非脑疝高血压性脑出血合并蛛网膜下腔出血患者60例为观察对象,根据随机数表法分为观察组与对照组,各30例。对照组给予单纯软通道钻孔引流术,观察组给予软通道钻孔引流术联合腰大池置管术,比较两组临床指标、术后脑积水并发症、格拉斯哥预后评分(GOS)。结果:观察组临床治疗脑内血肿清除率高于对照组,脑脊液转清时间、甘露醇用量及住院天数指标低于对照组,差异有统计学意义(P<0.05);两组患者在再出血、颅内感染方面比较,差异无统计学意义(P>0.05);观察组并发症脑积水发生率低于对照组,差异有统计学意义(P<0.05);观察组术后3个月GOS评分高于对照组,差异有统计学意义(P<0.05)。结论:采用软通道钻孔引流术联合腰大池置管,在非脑疝高血压性脑出血合并蛛网膜下腔出血患者手术治疗中的效果确切,具有安全、并发症少、促进神经功能恢复等优点。

Objective:To analyze the clinical effect of flexible channel drilling and drainage combined with lumbar cistern catheter in the treatment of non-herniated hypertensive intracerebral hemorrhage complicated with subarachnoid hemorrhage.Methods:From January 2014 to July 2022,60 patients with non-herniated hypertensive cerebral hemorrhage combined with subarachnoid hemorrhage who were admitted to the Department of Neurosurgery,Heze Hospital of Traditional Chinese Medicine,Shandong Province were selected as the observation objects.According to the random number table method,they were divided into observation group and control group,30 cases in each.The control group was given pure soft channel drilling and drainage,while the observation group was given soft channel drilling and drainage combined with lumbar cistern catheterization.The clinical indicators,postoperative complications of hydrocephalus,and Glasgow Outcome Scale(GOS)were compared between the two groups.Results:The clearance rate of intracerebral hematoma in the observation group was higher than that in the control group,and the time of cerebrospinal fluid clearing,the dosage of mannitol and the length of hospital stay were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in rebleeding and intracranial infection between the two groups(P>0.05).The incidence of complication of hydrocephalus in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The GOS score of the observation group was higher than that of the control group at 3 months after operation,and the difference was statistically significant(P<0.05).Conclusion:The use of flexible channel drilling and drainage combined with lumbar cistern intubation is effective in the surgical treatment of patients with non-herniated hypertensive intracerebral hemorrhage and subarachnoid hemorrhage,which has the advantages of safety,reducing complications,and promoting the recovery of nerve function.