摘要
目的探讨双侧脑室外引流联合颅内压(ICP)监测治疗重型脑室出血(SIVH)的临床疗效。方法回顾性分析了2015年7月至2017年1月安徽省立医院神经外科收治的62例SIVH患者的临床资料及治疗效果,根据手术方案分为观察组和对照组各31例,两组患者均行双侧脑室外引流术,但观察组一侧术中置入带有ICP监护探头的引流管。比较两组患者术后2 d、7 d脑室内血肿平均清除率,2 d、7 d患者意识状态(GCS评分),脑室引流时间、术后再出血率、颅内感染发生率、患者死亡率、3 m/6 m日常生活能力(ADL)评分等指标。结果观察组术后2 d、7 d脑室血肿平均清除率及GCS评分明显高于对照组(P <0. 05)。脑室外引流时间较对照组明显缩短(P <0. 05);然而,两组患者的术后再出血率无明显差异(P> 0. 05)。另外,观察组患者颅内感染发生率、住院期间死亡率及平均住院时间明显低于对照组(P <0. 05),随访6个月ADL 1~3级患者比率明显高于对照组(P <0. 05)。结论双侧脑室外引流联合ICP监测治疗SIVH优势明显,可迅速、安全廓清血肿,同时减少颅内感染的发生率,提高患者的生存率及生活质量,具有广阔的临床应用前景。
Objective The clinical effect of bilateral external ventricular drainage combined with intracranial pressure （ICP） monitoring for the treatment of severe intraventricular hemorrhage （SIVH） was studied. Methods Clinical data and therapeutic efficacy of 62 cases with SIVH who adimitted to Department of Neurosurgery, Anhni Provincial Hospital Affiliated to Anhni Medical University from July 2015 to January 2017 were analyzed retrospectively. All these 62 cases with SIVH were divided into observation group and control group with 31 patients in each. Surgical indications of all patients were confirmed and all patients were performed bilateral external ventricular drainage. The patients in the observation group were placed lateral ventricle drainage tube with ICP probe. Clearing of ventricle hematoma and CCS scores at 2 d and 7 d, the time of ventricle drainage, intracranial infection rate, average hospitalization time, mortality and the ability of daily life （ADL） scores at 6 months after treatment were compared between two groups. Results The ventricle henkatoma clearing rate and C, CS in observation group at 2 d and 7 d were significantly better than those of control group （P 〈 0. 05）. The time of ventricle drainage in observation group were obviously less than those in control group （P 〈0. 05）. The incidence of intracranial infection in observation group was significantly less than those in control group （P 〈0. 01 ）. Post-operative rebleeding rate in two groups showed no significant difference （P 〉0. 05）. Besides, the mortality- and average hospitalization time were less than that of the control group （P 〈0. 05）. Finally, the percentage of patients of ADL 1 -3 level in observation group was significantly higher than that of control group （P 〈0. 05）. Conclusion Bilateral external ventricular drainage combined with ICP monitoring for the treatment of SIVH has the advantages of rapidly and safely removing henkatoma and decreasing the rate of intracranial infection, so it can improve the survival rate and daily life ability of patients and has a broad prospect in clinical practices.
作者
汪洋
鲍得俊
程传东
董永飞
汪大胜
魏祥品
牛朝诗
傅先明
汪业汉
WANG Yang;BAO Dejun;CHENG Chuandong;DONG Yongfei;WANG Dasheng;WEI Xiangpin;NIU Chaoshi;FU Xianming;WANG Yehan(Department of Neurosurgery,Anhui Provincial Hospital Affiliated to Anhui Medical University,Hefei 230001,China)
出处
《中华神经外科疾病研究杂志》
CAS
2018年第5期406-410,共5页
Chinese Journal of Neurosurgical Disease Research
基金
安徽省自然基金青年项目资助项目(1508085QH184)
关键词
重型脑室出血
脑室外引流
颅内压监测
再出血
颅内感染
Severe intraventrieular hemorrhage
Extenkal venlrieular drainage
Intraeranial pressure monitoring
Rebleeding rate
Intraeranial infection
