本文關(guān)鍵詞： 持續(xù)腰大池引流（LCFD） 重型顱腦損傷 外傷性蛛網(wǎng)膜下腔出血（tSAH）　出處：《蘇州大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討術(shù)后持續(xù)腰大池引流對重型顱腦損傷合并蛛網(wǎng)膜下腔出血（tSAH）的治療效果。 方法：選取我院自2011年10月至2013年5月收治的重型顱腦損傷合并tSAH的患者60例，于開顱術(shù)后隨機(jī)分為兩組，實驗組30例，行持續(xù)腰大池引流術(shù)引流腦脊液；對照組30例，行多次腰椎穿刺術(shù)放腦脊液；從GCS評分、腦脊液紅細(xì)胞計數(shù)檢測、蛛網(wǎng)膜下腔積血清除時間、并發(fā)癥（腦積水、腦梗塞）的發(fā)生率及療效預(yù)后各方面對兩組治療方法進(jìn)行評價。 結(jié)果：兩組患者治療5、10d后GCS評分較治療前顯著提高，且治療后5、10d時實驗組GCS評分顯著高于對照組（P＜0.05或P＜0.01)；實驗組腦脊液中紅細(xì)胞＜100×106/L的時間較對照組明顯提前（P＜0.01)；通過術(shù)后復(fù)查頭顱CT觀察蛛網(wǎng)膜下腔出血消散情況，實驗組明顯優(yōu)于對照組（P＜0.05）；實驗組術(shù)后腦積水發(fā)生率明顯低于對照組（P＜0.05）；出院時按GOS評定預(yù)后，，實驗組也明顯優(yōu)于對照組（P＜0.05）。 結(jié)論：重型顱腦損傷合并蛛網(wǎng)膜下腔出血術(shù)后早期行腰大池持續(xù)外引流能清除血性腦脊液，減少并發(fā)癥，改善預(yù)后，持續(xù)腰大池引流在掌握其適應(yīng)征的前提下是一種比較安全和有效的治療方法。
[Abstract]:Objective: to investigate the effect of continuous lumbar cistern drainage on severe craniocerebral injury with subarachnoid hemorrhage. Methods: from October 2011 to May 2013, 60 patients with severe craniocerebral injury complicated with tSAH were randomly divided into two groups: the experimental group (n = 30) and the control group (n = 30). The treatment methods of the two groups were evaluated from the aspects of GCS score, cerebrospinal fluid red blood cell count, subarachnoid hemorrhage clearance time, complications (hydrocephalus, cerebral infarction) and prognosis. Results: the GCS score of the two groups was significantly higher than that before treatment for 5 ~ 10 days. The GCS score in the experimental group was significantly higher than that in the control group (P < 0. 05 or P < 0. 01), the time of erythrocyte < 100 脳 10 6 / L in cerebrospinal fluid in the experimental group was significantly earlier than that in the control group (P < 0. 01). The incidence of hydrocephalus in the experimental group was significantly lower than that in the control group (P < 0.05), and the prognosis was assessed according to GOS at discharge, and the experimental group was also significantly better than the control group (P < 0.05). Conclusion: continuous external drainage of lumbar cistern after severe craniocerebral injury combined with subarachnoid hemorrhage can clear cerebrospinal fluid, reduce complications and improve prognosis. Continuous lumbar cistern drainage is a safe and effective treatment under the condition of mastering its adaptive sign.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R651.15

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 黃清海,劉建民,許奕,周曉平,洪波,趙文元,何鎣;腰椎穿刺蛛網(wǎng)膜下腔置管持續(xù)引流防治腦血管痙攣的初步觀察[J];第二軍醫(yī)大學(xué)學(xué)報;2001年08期

2 李國平,黃思慶,惠旭輝,楊開勇,游潮,毛伯鏞,易章超;289例持續(xù)腰池腦脊液引流在神經(jīng)外科應(yīng)用的臨床總結(jié)[J];華西醫(yī)學(xué);2000年01期

3 張兆勇;薛軍;劉文生;王年齡;馬淮濱;;持續(xù)腰大池引流在重型顱腦損傷術(shù)后的輔助應(yīng)用[J];臨床神經(jīng)外科雜志;2009年04期

4 顧征,徐愛民,孫永權(quán),孫興武;持續(xù)腰大池引流腦脊液的安全性及臨床應(yīng)用的探討[J];腦與神經(jīng)疾病雜志;2004年01期

5 李亞龍;劉巧英;劉樹鵬;;腰大池持續(xù)引流用于開顱術(shù)后60例臨床分析[J];四川醫(yī)學(xué);2011年07期

6 馮志鐵;譚國據(jù);林強(qiáng);;早期腰大池持續(xù)引流治療外傷性蛛網(wǎng)膜下腔出血[J];實用全科醫(yī)學(xué);2008年06期

7 艾艷平;;創(chuàng)傷性蛛網(wǎng)膜下腔出血臨床治療分析[J];中國醫(yī)藥導(dǎo)報;2010年02期

8 黃輝;王知非;劉輝;龍爍;劉峰;廖達(dá)光;;持續(xù)腰大池引流腦脊液在蛛網(wǎng)膜下腔出血患者中的臨床應(yīng)用[J];中風(fēng)與神經(jīng)疾病雜志;2006年06期

9 任紅兵,宋倫賢,吳成亞,熊焰;腰大池置管持續(xù)外引流治療外傷性腦脊液漏[J];中國臨床神經(jīng)外科雜志;2005年04期

10 馮偉;張新定;;腰大池引流治療外傷性蛛網(wǎng)膜下腔出血38例分析[J];中國臨床神經(jīng)外科雜志;2012年02期

本文編號：1544162