开颅术后硬膜下引流在80例颅脑损伤患者中的应用

Clinical Application of Subdural Out Drain of Grass-roots Hospital in Severe Craniocerebral Injure

目的 :根据我院应用硬脑膜下外引流在基层医院治疗重型颅脑损伤的经验 ,对其临床价值进行评估。方法 :对80例重型颅脑损伤者 ,在行病灶清除术去骨瓣减压术时 ,同时做硬脑膜下 ,低位枕后方向外引流(引流时间为5～7d)。结果 :本组80例中 ,存活58例 ,存活率72 5%;死亡22例 ,死亡率27 5%。每日引流量少于50ml者全部死亡 ,死亡20例 ;每日引流量超过50ml者且在术后5～d内逐渐增多达300ml以上者58例 ,仅死亡2例。结论 :在术后观察引流量 ,能够评估颅内压的高低以及患者的预后。每日引流量少于50ml者预后不佳 。

Objective:According to our experiences of treating severe craniocerebral injure by using subdural out drain in grass-roots hospital to evaluate the value of its clinical application.Methods:Lesions of 80 cases of severe craniocerebral injure were excised and the bone piston decompression was performed.At the same time the subdural out drain of lower pulvinar was done to persist 5～7 days.Results:58 of 80 cases were alive.The survival rate was 72.5%.22 cases died and the mortality was 27.5%.All 22 of the patients that drain quantity were less than 50 ml died.Only 2 cases died among 58 cases whose drain quantity were more than 50 ml or increased to 300ml.Results:According to the drain quantity we can evaluate intracranial pressure and prognosis of the patients.Conclusions:The prognosis is bad in the patients whose drain quantity is less than 50ml.If the drain quantity is more than 50ml or increases gradually,the prognosis is good.