脑室+联合侧裂池外引流救治合并SAH的弥漫性轴索损伤疗效分析

目的探讨脑室联合侧裂池外引流救治中、重型弥漫性轴索损伤(DAI)合并广泛蛛网膜下腔出血(SAH)的疗效。方法回顾性分析了1998-04～2003-04救治的GCS3～12分中、重型弥漫性轴索损伤(DAI)合并广泛蛛网膜下腔出血68例。其中A组38例,行脑室联合侧裂池外引流及后期腰穿置管引流;B组30例,单纯行腰穿放脑脊液。结果A组患者死亡率和致残率明显低于B组,而预后良好率明显高于B组,两组差异有显著性(P<0.05)。结论脑室联合侧裂池外引流救治中、重型DAI合并SAH能明显降低患者的死亡率和致残率,值得推广应用。

The outcome analysis of external drainage to save the diffuse axonal injury and complicated subarachnoid hemorrhage via lateral ventricle and cistern fissure sylvian

Objective To investigate therapeutic effect via lateral ventricle a nd cistern fissure sylvian external drainage in saving the diffuse axonal injury and complicated extensive subarachnoid hemorrhage (SAH). Methods The 68 patien ts with scores of 3-12 on GCS who were admitted to our department from Apr. 1998 to Apr. 2003 were analyzed retrospectively. The 38 patients as one group (A gro up),were suffered to apply lateral ventricle and cistern fissure sylvian externa l drainage, and later to lumbar puncture to install peridural anesthesia tube in order to drainage blood cerebrospinal fluid(CSF); other 30 patients as another group (B group), to apply lumbar puncture to substitute blood CSF.Results Acc ording to the standard of GOS prognosis,the mortality and mutilation rate of A g roup patients was much lower than of B group patients,and good rate of A group patients was much higher than of B group patients, by contrast there was signifi cant difference(P<0.05). Conclusion External drainage via lateral ventricle and cistern fissure sylvian in saving diffuse axonal injury and complicated extensi ve subarachnoid hemorrhage (SAH), can significantly decrease the patients mortal ity and mutilation rate , and it is worthy to popularization.