本文選題：腰大池持續(xù)引流　切入點(diǎn)：Chiari畸形　出處：《濟(jì)南大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的評(píng)價(jià)腰大池持續(xù)外引流術(shù)對(duì)預(yù)防Chiari畸形I型術(shù)后并發(fā)癥發(fā)生的有效性及安全性。方法選取我院2013年1月-2014年5月收治的chiari畸形I型患者60例,所有換均合并不同程度的脊髓空洞。將入選患者隨機(jī)分為2組,治療組30和對(duì)照組30例。治療組在術(shù)后第1天行腰大池置管外引流,對(duì)照組在術(shù)后第1天未行腰大池置管外引流,治療一周后,采用自身前后對(duì)比及實(shí)驗(yàn)組與對(duì)照組組間對(duì)比的方法,觀察兩組患者同步、定期腦脊液生化指標(biāo)檢測結(jié)果中白細(xì)胞、氯化物含量、葡萄糖含量及蛋白定量指標(biāo)的變化情況。同時(shí)觀察兩組患者術(shù)后并發(fā)癥如術(shù)后發(fā)熱、皮下積液、切口腦脊液漏、顱內(nèi)感染的發(fā)生率情況,以及切口愈合情況及住院時(shí)間的變化情況。結(jié)果1、兩組同步腦脊液生化指標(biāo)比較腦脊液生化指標(biāo)檢查結(jié)果示:治療組的白細(xì)胞計(jì)數(shù)及蛋白定量呈明顯下降趨勢(shì),對(duì)照者的則呈緩慢下降趨勢(shì),兩組有明顯統(tǒng)計(jì)學(xué)意義(P0.05)2、兩組術(shù)后并發(fā)癥的發(fā)生率的比較治療組術(shù)后無一例患者發(fā)生顱內(nèi)感染,對(duì)照組有5例患者發(fā)生顱內(nèi)感染,兩組比較p=0.071,其差異有統(tǒng)計(jì)學(xué)意義。治療組術(shù)后有一例患者出現(xiàn)皮下積液,對(duì)照組有4例患者發(fā)生皮下積液,兩組比較p=0.056,差異無統(tǒng)計(jì)學(xué)意義。3、兩組術(shù)后住院時(shí)間的比較治療組平均住院天數(shù)為(10.564±2.236)天,對(duì)照組(14.354±1.532)天,兩組差異有統(tǒng)計(jì)學(xué)意義(P0.01)。4、兩組術(shù)后切口愈合情況比較治療組與對(duì)照組切口均愈合良好,均未出現(xiàn)腦脊液漏,兩組比較無差異,無統(tǒng)計(jì)學(xué)意義。結(jié)論Chiari畸形I型術(shù)后常規(guī)給予腰穿置管腦脊液外引流術(shù)能有效預(yù)防術(shù)后顱內(nèi)感染、皮下積液、腦脊液漏及腦積水的發(fā)生,能有效減少抗生素的應(yīng)用、縮短住院時(shí)間以減輕患者的經(jīng)濟(jì)負(fù)擔(dān),具有較好的臨床療效,值得臨床推廣。
[Abstract]:Objective to evaluate the efficacy and safety of continuous external drainage of lumbar cistern for the prevention of postoperative complications of Chiari malformation type I. methods 60 patients with type I chiari malformation admitted in our hospital from January 2013 to May 2014 were selected. All the patients with syringomyelia were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). After one week of treatment, the patients in the control group were compared with each other before and after treatment. The white blood cells of the two groups were observed synchronously and periodically, and the results of cerebrospinal fluid biochemical indexes were measured regularly. The changes of chloride content, glucose content and protein quantitative index were also observed. The incidence of postoperative complications such as postoperative fever, subcutaneous effusion, cerebrospinal fluid leakage and intracranial infection were observed in both groups. Results 1.Compared with the biochemical indexes of cerebrospinal fluid in the two groups, the results showed that the white blood cell count and protein quantity of the treatment group were obviously decreasing. The incidence of postoperative complications in the two groups was significantly higher than that in the control group. There was no intracranial infection in the treatment group and 5 patients in the control group. The difference between the two groups was statistically significant. One patient in the treatment group had subcutaneous effusion after operation, and four patients in the control group had subcutaneous effusion. There was no significant difference between the two groups. The average length of hospitalization was 10.564 鹵2.236 days in the treatment group and 14.354 鹵1.532 days in the control group. There was significant difference between the two groups (P 0.01). There was no significant difference between the treatment group and the control group in the wound healing, and no cerebrospinal fluid leakage was found in the treatment group and the control group, but there was no difference between the two groups. Conclusion the routine drainage of cerebrospinal fluid through lumbar puncture can effectively prevent the occurrence of intracranial infection, subcutaneous effusion, cerebrospinal fluid leakage and hydrocephalus, and can effectively reduce the use of antibiotics. Shortening the hospitalization time to reduce the economic burden of patients has better clinical effect and is worth popularizing.
【學(xué)位授予單位】：濟(jì)南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R651.2

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