侧脑室钻孔引流术结合LCFD术治疗老年脑室出血的临床研究

目的 探讨侧脑室钻孔引流术结合腰大池持续引流术(lumbar cistern countinue drainage,LCFD)治疗老年脑室出血的有效性,并分析术后并发颅内感染的Logistic的危险因素.方法 前瞻性选取本院2015年9月至2020年3月接诊的老年脑室出血患者88例,按照随机数字表法将患者分为对照组和研...

Efficacy of lateral ventricle drilling and drainage combined with LCFD in the treatment of senile ventricular hemorrhage and logistic regression analysis of postoperative intracranial infection

Objective To investigate the effectiveness of lateral ventricle drilling drainage combined with lumbar cistern continuous drainage(LCFD)in the treatment of elderly patients with intraventricular hemorrhage,and to analyze the logistic risk factors of postoperative intracranial infection.Methods 88 elderly patients with intraventricular hemorrhage in our hospital from September 2015 to March 2020 were prospectively selected and randomly divided into control group and study group,with 44 cases in each group.The control group was treated with lateral ventricle drilling and drainage,and the study group was treated with lateral ventricle drilling and drainage combined with LCFD.The curative effect,Glasgow Coma Scale(GCS)and Glasgow outcome score before and after treatment were compared between the two groups The risk factors of postoperative intracranial infection were analyzed by univariate and multivariate logistic regression.Results The total effective rate of the study group was significantly higher than that of the control group(χ²=5.91,P<0.05).There was no difference in GCS score and GOS score before treatment(P>0.05),but increased after treatment(P<0.05).GCS score and GOS score of study group were significantly higher than those of control group and t=5.44,9.89,P<0.05).The hematoma clearance time of the study group was lower than that of the control group,and the hematoma clearance rate 3 days after operation was significantly higher than that of the control group(t=8.81,9.00,P<0.05).A total of 14 patients(15.9%)had postoperative intracranial infection.Univariate and multivariate logistic regression analysis showed that diabetes mellitus(OR=23.477,95%CI 0.279~50.350),skin infection of surgical incision(OR=48.135,95%CI 4.388~528.013)and timing of operation(OR=48.135,95%CI 4.388~528.013)were the main causes of postoperative intracranial infectio(OR=633,95%CI 1.203~94.021)was an independent risk factor for postoperative intracranial infection in elderly patients with intraventricular hemorrhage(P<0.05).Conclusion Lateral ventricle drilling drainage combined with LCFD is effective in the treatment of elderly patients with intraventricular hemorrhage,which can shorten the hematoma clearance time,improve coma status and prognosis,and diabetes mellitus,operation timing and postoperative incision infection are the risk factors of postoperative intracranial infection,such patients should be intervened and prevented in advance.