腰大池持续引流预防脑出血破入脑室后慢性脑积水的研究(1)
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[摘要] 目的 研究腰大池持续引流对脑出血破入脑室后慢性脑积水的预防效果。方法 对120例脑出血破入脑室患者随机分组，对照组常规治疗，实验组除常规治疗外行腰大池置管持续引流。为规避手术方式不同对脑积水发生率的影响，实验组和对照组间按有无去骨瓣减压各分两个亚组；将实验组和对照组的慢性脑积水的发生率进行总结分析。结果 实际有效病例115例，实验组中非减压亚组的脑积水发生率明显低于对照组中非减压亚组，组间差异具有显著性意义(P<0.05)。结论 腰大池持续引流能减少脑出血破入脑室后慢性脑积水的发生，对以脑室积血为主，不需要开颅去骨瓣减压手术的病例，效果尤其显著。
[关键词] 脑出血；腰大池引流；脑积水
[中图分类号] R651.12 [文献标识码] B [文章编号] 1673-9701(2011)24-58-02
Lumbar Continuous Drainage Prevention of Cerebral Hemorrhage after Breaking into the Ventricle of Chronic Hydrocephalus
YU Yijun LOU Xiaohui CHEN Ning CHEN Peng YANG Xiaoqing
Neurosurgery Department，Rui'an People's Hospital，Rui'an 325000，China
[Abstract] Objective To study the lumbar continuous drainage of cerebral hemorrhage after breaking into the ventricles of the preventive effect of chronic hydrocephalus. Methods All 120 cases of cerebral hemorrhage broken into ventricles were randomly divided into two groups，control group was given conventional therapy control group，the experimental group in addition to conventional treatment，the line continuous lumbar drainage catheter. To avoid the different ways of surgery on the incidence of hydrocephalus，the experimental group and control group according to whether decompressive craniectomy，set two sub-groups，respectively；Analyze the incidence of chronic hydrocephalus of the experimental groups and control groups. Results All 115 cases were the actual effective cases，the incidence of hydrocephalus in the experimental sub-group of non-decompression was significantly lower than the control sub-group of non-decompression，the differences between the groups was significant(P<0.05). Conclusion Continuous lumbar drainage reduces the occurrence of chronic hydrocephalus after cerebral hemorrhage breaking into the ventricles，and the effect is particularly notable to the cases that intraventricular hemorrhage in the main and do not need cranial decompression craniectomy.
[Key words] Cerebral hemorrhage；Lumbar drainage；Hydrocephalus
脑积水是脑出血后常见的并发症之一。尤其是出血破入脑室系统后，其发生率更高。慢性脑积水发生在患者恢复阶段，会阻碍患者神经功能恢复，造成其生存质量下降，甚至再次危及生命。本研究选择2008年1月～2010年9月我院神经外科收治的高血压基底节脑出血破入脑室患者120例，随机分两组对照分析，并将两种不同术式(开颅减压手术与单纯脑室外引流手术)的患者分亚组进行分析 ......
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