双侧脑室引流联合脑脊液置换治疗重型脑室出血的可行性分析
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摘要
目的将双侧脑室引流治疗方法联合脑脊液置换治疗方法实行于重型脑室出血患者中,分析及评定联合治疗的可行性。方法依据治疗方法差异区分和分析方便选取的2015年6月—2017年7月临沧市人民医院收入的60例重型脑室出血患者,将其分成参照组和实验组,常规治疗均予以两组患者,双侧脑室引流治疗方法用于参照组(n=30),双侧脑室引流治疗方法联合脑脊液置换治疗方法用于实验组(n=30),观察两组患者的术后48 h神志清楚总计率、术后第7天CT检查脑室血肿基本清除总计率、有效总计值、引流时间平均值。结果实验组患者的术后48 h神志清楚总计率66.67%、术后第7天CT检查脑室血肿基本清除总计率86.67%、有效总计值86.67%对比参照组患者46.67%、60.00%、53.33%更高(χ2=8.144 9、18.187 0、26.465 6,P<0.05);实验组患者的引流时间平均值(4.2±0.4)d对比参照组患者(8.7±1.0)d更低(t=22.884 6,P<0.05)。结论重型脑室出血患者接受双侧脑室引流治疗方法联合脑脊液置换治疗方法呈现显著效果,体现应用可行性。
Objective To analyze and evaluate the feasibility of bilateral ventricle drainage combined with Cerebrospinal fluid displacement in treatment of severe ventricular hemorrhage. Methods 60 cases of patients with severe ventricular hemorrhage admitted and treated in our hospital from June 2015 to July 2017 were convenient selected and divided into two groups according to different treatment methods, with 30 cases in each, the control group were treated with bilateral ventricle drainage, while the experimental group were treated with bilateral ventricle drainage combined with cerebrospinal fluid displacement, and total rate of 48 h consciousness, total rate of ventricle hematoma basic clearance of CT examination in 7 d after surgery, total effective rate and average value of drainage time of the two groups were observed. Results The total rate of 48 h consciousness, total rate of ventricle hematoma basic clearance of CT examination in 7 d after surgery, total effective rate in the experimental group were higher than those in the experimental group [66.67%, 86.67%, 86.67% vs46.67%,60.00%,53.33%],and the differences were statistically significant(χ2=8.144 9,18.187 0,26.465 6,P<0.05), and the average value of drainage time in the experimental group was lower than that in the control group, [(4.2±0.4)d vs(8.7±1.0)d],and the difference between the two groups was statistically significant(t=22.884 6,P<0.05). Conclusion The effect of bilateral ventricle drainage combined with cerebrospinal fluid displacement in treatment of severe ventricular hemorrhage is obvious,with feasibility.
Objective To analyze and evaluate the feasibility of bilateral ventricle drainage combined with Cerebrospinal fluid displacement in treatment of severe ventricular hemorrhage. Methods 60 cases of patients with severe ventricular hemorrhage admitted and treated in our hospital from June 2015 to July 2017 were convenient selected and divided into two groups according to different treatment methods, with 30 cases in each, the control group were treated with bilateral ventricle drainage, while the experimental group were treated with bilateral ventricle drainage combined with cerebrospinal fluid displacement, and total rate of 48 h consciousness, total rate of ventricle hematoma basic clearance of CT examination in 7 d after surgery, total effective rate and average value of drainage time of the two groups were observed. Results The total rate of 48 h consciousness, total rate of ventricle hematoma basic clearance of CT examination in 7 d after surgery, total effective rate in the experimental group were higher than those in the experimental group [66.67%, 86.67%, 86.67% vs46.67%,60.00%,53.33%],and the differences were statistically significant(χ2=8.144 9,18.187 0,26.465 6,P<0.05), and the average value of drainage time in the experimental group was lower than that in the control group, [(4.2±0.4)d vs(8.7±1.0)d],and the difference between the two groups was statistically significant(t=22.884 6,P<0.05). Conclusion The effect of bilateral ventricle drainage combined with cerebrospinal fluid displacement in treatment of severe ventricular hemorrhage is obvious,with feasibility.
引文
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[2]刘永飞,仇汉诚,赵贵锋,等.重型脑室出血脑室外引流与保守治疗出院结局的回顾性分析[J].中华医学杂志,2017,97(29):2257-2260.
[3]李作士,林东洋,江楠,等.急诊双侧脑室穿刺尿激酶灌洗联合腰大池引流治疗急性重型脑室出血的疗效观察[J].中国医药指南,2014,12(22):194-196.
[4]郭金光,李海燕,王绍飞,等.重型脑室出血灌注尿激酶后不同保留时间的疗效观察[J].中华神经外科疾病研究杂志,2017,16(5):432-436.
[5]张施远,曾春,蒋永明,等.重型脑室出血并铸型的不同手术方式临床分析[J].中国临床神经科学,2015(4):450-453.
[6]郭金光,李海燕,王竞,等.重型脑室出血外引流注入尿激酶后保留时间的探讨[J].中国医师进修杂志,2017,40(2):142-144.
[7]张同星.经纵裂-胼胝体入路手术治疗重型脑室出血并铸型12例疗效观察[J].中国现代药物应用,2014(13):51-52.
[8]王远传.双侧脑室引流联合脑脊液置换治疗重型脑室出血的可行性研究[J].医药前沿,2017,7(26):56-57.