摘要
目的探讨脑出血破入脑室临床治疗中颅骨钻孔侧脑室引流联合腰大池持续引流术的应用效果。方法选取2015年6月—2020年5月该院收治的脑出血破入脑室患者102例,按照随机数表法,分为对照组与治疗组,各51例。对照组接受单纯颅骨钻孔侧脑室引流治疗,治疗组接受侧脑室引流联合腰大池持续引流,比较两组意识与血肿消除效果、临床疗效、术后简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分、日常生活活动能力(ADL)评分与术后6周格拉斯哥结局评分(GOS)结果。结果相较于对照组,治疗组术后3 d意识转清率(9.80%vs 27.45%)、术后2周血肿基本清除率(54.90%vs 84.31%)均更高,侧脑室平均引流时间[(13.14±2.53)d vs(6.24±1.50)d]更短,差异有统计学意义(χ^(2)=5.239、10.427,t=16.753,P<0.05);相较于对照组,治疗组术后1个月、2个月的MMSE评分、MoCA评分与ADL评分均更高,差异有统计学意义(P<0.05);相较于对照组,治疗组术后6周GOS评分更高,差异有统计学意义(P<0.05);相较于对照组,治疗组治疗总有效率更高,差异有统计学意义(P<0.05)。结论脑出血破入脑室临床治疗中颅骨钻孔侧脑室引流术联合腰大池持续引流的疗效确切,可以提高血肿清除效果,缩短侧脑室引流时间,加快患者意识恢复,改善其疾病预后。
Objective To investigate the application effect of cranial drilling lateral ventricle drainage combined with lunbear cistern continuous drainage in the clinical treatment of cerebral hemorrhage breaking into ventricle.Methods From June 2010 to May 2025,102 patients with intracerebral hemorrhage broken into ventricle were selected and randomly divided into control group and treatment group,51 cases in each group.The control group was treated with simple cranial drilling lateral ventricle drainage,and the observation group was treated with lateral ventricle drainage combined with continuous lumbar cistern drainage.The consciousness and hematoma elimination effect,clinical efficacy,MMSE,MoCA,ADL and Glasgow Outcome Score(GOS)of the two groups were compared.Results Compared with the control group,the treatment group had a higher 3 d consciousness transition rate(9.80%vs 27.45%)and a hematoma clearance rate(54.90%vs 84.31%)at 2 weeks after the operation,the average drainage time of the lateral ventricle[(13.14±2.53)d vs(6.24±1.50)d]was shorter,and the difference was statistically significant(χ^(2)=5.239,10.427,t=16.753,P<0.05);compared with the control group,the MMSE score,MoCA score and ADL score of the treatment group were higher at 1 month and 2 months after operation,and the difference was statistically significant(P<0.05);compared with the control group,the observation group had a higher GOS score at 6 weeks after surgery,and the difference was statistically significant(P<0.05);compared with the control group,the observation group had a higher total effective rate of treatment,and the difference was statistically significant(P<0.05).Conclusion In the clinical treatment of intracerebral hemorrhage breaking into ventricle,cranial drilling lateral ventricle drainage combined with lumbar cistern continuous drainage has definite curative effect,which can improve the effect of hematoma clearance,shorten the drainage time of lateral ventricle,accelerate the recovery of consciousness and improve the prognosis of the disease.
作者
吴自成
陈新成
孟伟
孙来生
王余军
杨星
WU Zicheng;CHEN Xincheng;MENG Wei;SUN Laisheng;WANG Yujun;YANG Xing(Department of Neurosurgery,Xinyi People's Hospital,Xinyi,Jiangsu Province,221400 China)
出处
《世界复合医学》
2021年第9期110-113,共4页
World Journal of Complex Medicine
关键词
脑出血
脑室
侧脑室引流术
腰大池引流
简易智力状态检查量表
格拉斯哥结局评分
Cerebral Hemorrhage
Ventricles
Lateral ventriculotomy
Lumbar cistern drainage
Simple intelligence state checklist
Glasgow Outcome Score
