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岭南现代临床外科 ›› 2015, Vol. 15 ›› Issue (03): 294-296.DOI: j.issn.1009-976X.2015.03.014

• 论著与临床研究 • 上一篇    下一篇

腰椎穿刺脑脊液置换术对颅脑损伤伴蛛网膜下腔出血治疗经验

陈雪江 党伟 梁荣芳   

  1. 深圳市光明新区人民医院神经外科
  • 通讯作者: 陈雪江

Lumbar puncture and cerebrospinal fluid replacement surgery for severe traumatic brain injury with the treatment of subarachnoid hemorrhage

Chen Xuejiang, Dang Wei, Liang Rongfang   

  • Received:2015-03-23 Revised:2015-05-17 Online:2015-06-20 Published:2015-06-20

摘要: 【摘要】〓目的〓总结腰椎穿刺脑脊液置换术对重型颅脑损伤伴蛛网膜下腔出血的治疗体会。方法〓选取2012年1月~2014年3月间55例重型颅脑损伤伴蛛网膜下腔出血患者接受腰椎穿刺脑脊液置换术作为研究组,另选择同期接受常规救治的该类患者作为对照。对比两组血性脑脊液的清除时间、并发症发生率及临床疗效。结果〓研究组血性脑脊液的清除时间为8.13±1.25 d,对照组为 9.37±1.49 d(P<0.05);研究组脑梗死、脑积水、癫痫发生率分别为0、1.82%、3.64%。对照组分别为9.09%、12.73%、14.55%(P<0.05);研究组患者GOS评定良好率为52.73%,对照组为25.45%(P<0.01);研究组疗效GOS评定重残率、植物生存率及死亡率分别为14.55%、1.82%、0,对照组分别为30.91%、14.55%、7.27%(P<0.05)。结论〓腰椎穿刺脑脊液置换术治疗重型颅脑损伤伴蛛网膜下腔出血可加快血性脑脊液的清除,并降低并发症发生率,同时还能有效的改善预后,临床疗效满意。

关键词: 腰椎穿刺脑脊液置换术, 重型颅脑损伤, 蛛网膜下腔出血

Abstract: 【Abstract】〓Objective〓To investigate the lumbar puncture and cerebrospinal fluid replacement for treatment of traumatic brain injury with subarachnoid hemorrhage. Methods〓Fifty?鄄five cases of severe traumatic brain injury patients with subarachnoid hemorrhage underwent surgical treatment of lumbar puncture and cerebrospinal fluid replacement (observation group) from Jan 2012 to Mar 2014. Another 55 cases who received conventional treatment were chosen as control group. Bloody cerebrospinal fluid (BCSF) clearance time, complications, clinical efficacy were evaluated and compared between two groups. Results〓BCSF clearance time were 8.13±1.25 d, 9.37±1.49 d respectively in observation and control group and there was difference between two groups (P<0.05). Infarction, hydrocephalus, epilepsy incidence in observation group were 0, 1.82%, 3.64%, respectively and were 9.09%, 12.73%, 14.55% in control group(P<0.05). The rate of good by GOS score in observation group GOS was 52.73%, and 25.45% in control group (P<0.01). Severe disability rate, plant survival and mortality rates were 14.55%, 1.82%,0, respective in observation, and, 30.91%, 14.55%, 7.27% in control group (P<0.05). Conclusion〓Lumbar puncture and cerebrospinal fluid replacement therapy for severe traumatic brain injury with subarachnoid hemorrhage can reduce the incidence of complications, improve the prognosis.

Key words: Lumbar puncture and cerebrospinal fluid replacement, Severe brain injury, Subarachnoid hemorrhage

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