脑室外引流联合腰大池置管引流治疗脑室出血疗效观察

目的探讨脑室外引流联合腰大池置管引流治疗脑室出血的临床疗效,为其治疗研究提供可参考依据。方法 60例脑室出血患者分为对照组与观察组,每组30例。在常规治疗基础上,对照组患者给予脑室外引流,观察组患者给予脑室外引流联合腰大池置管引流治疗,观察患者手术后3、7 d脑室内出血清除情况及临床疗效。结果观察组患者手术后3、7 d脑室出血清除率明显高于对照组,差异有统计学意义(P<0.05);观察组脑室出血清除时间及脑脊液恢复正常时间明显短于对照组,差异有统计学意义(P<0.05)。观察组患者总有效率明显高于对照组,而颅内感染率低于对照组,差异有统计学意义(P<0.05)。手术后3、7 d,2组血清神经元特异性烯醇化酶(NSE)均有明显下降(P<0.05);与对照组患者相比,观察组患者下降更明显,差异有统计学意义(P<0.05)。而手术后3、7 d 2组血清铁蛋白(SF)水平均较手术前高(P<0.05),但观察组患者血清SF水平均低于对照组,差异有统计学意义(P<0.05)。结论脑室外引流联合腰大池置管引流可以更好地清除脑室出血,并对脑损伤指标NSE及SF有较好的改善作用。

External ventricular drainage combined with lumbar pool catheter drainage treatment on intraventricular hemorrhage

Objective To study external ventricular drainage combined with lumbar pool catheter drainage treatment of intraventricular hemorrhage. Methods Sixty patients with intraventricular hemorrhage were chosen and divided into observation group and control group,with 30 patients in each group. On the basis of conventional treatment,the control group and observation group were given single ventricle drainage and intraventricular external drainage combined with lumbar big pool catheter drainage treatment respectively. Clearing and clinical curative effect in patients with intraventricular hemorrhage were observed at 3 and 7 d after treatment. Results The clearing rate of patients in observation group with 3,7 d ventricular hemorrhage was significantly more than the control group,the difference was statistically significant（ P 0. 05）; clearing time of intraventricular hemorrhage and time of normal cerebrospinal fluid in observation group were obviously less than those in control group,the differences were statistically significant（ P 0. 05）. Total effective rate of patients in observation group was significantly higher than that in the control group while intracranial infection rate was lower than that in the control group,the differences were statistically significant（ P 0. 05）. At 3 and 7 d after the operation,serum neuron-specific enolase（ NSE） level in the 2 groups were decreased significantly than before treatment,and compared with the control group,observation group decreased more obviously,the difference was statistically significant（ P 0. 05）. At 3 and 7 d after the operation,serum ferritin（ SF） level increased significantly than before treatment,and compared with the control group,observation group increased more obviously,the difference was statistically significant（ P 0. 05）. Conclusion External ventricular drainage combined with lumbar pool catheter drainage treatment can remove intraventricular hemorrhage preferably,improve the brain damage index NSE and SF of the patients.