腰大池置管引流脑脊液置换治疗 蛛网膜下腔出血的并发症及处理.docVIP

精品论文 参考文献 腰大池置管引流脑脊液置换治疗 蛛网膜下腔出血的并发症及处理 卢家璋1 陈善成2 包陆君1 谢才兰1 陈均昌1 刘海生1 1.广东医学院附属陈星海医院神经外科 广东 中山 528415 2.暨南大学附属第一医院神经外科 广州 510630 【摘要】 目的 探讨腰大池置管引流脑脊液置换治疗蛛网膜下腔出血并发症出现的原因及处理对策。方法 收集2010 年12 月至2011 年12 月我科应用腰大池 置管脑脊液置换治疗蛛网膜下腔出血63 例病例资料，回顾分析所有病人腰大池置管引流效果及并发症发生情况。结果 留管时间1-29 天，平均5.87plusmn;1.04 天。症 状改善情况：显效43 例，有效17 例，无效3 例。并发症：无并发症22 例，脑疝1 例，再次脑出血2 例，迟发型脑积水3 例，置管失败3 例，低颅压6 例，堵管 15 例，自拔管6 例，拔管后术口渗液5 例，引流不畅6 例，硬膜下积液1 例，神经根痛3 例。结论 腰大池置管引流能快速引流血性脑脊液，缩短蛛网膜下腔出血 患者的治疗时间，加快患者的恢复，虽有不同程度的并发症，只要注意预防，均可避免，值得在临床推广。 【关键词】蛛网膜下腔出血 腰大池 引流 脑脊液 并发症 Complication and countermeasure of continued lumbar cerebrospinal fluid drainage (CLCFD) to treat Subarachnoid hemorrhage (SAH) LU Jiazhang*, CHEN Shancheng**, BAO Lujun*, XIE Cailan*, CHEN Junchang*, LIU Haisheng*. *Department of Neurosurgery, Affiliated Chenxinghai hospital of Guangdong Medical College 528415, China ** Department of Neurosurgery, The First Affiliated Hospital of Jinan University 510630, China Abstract: Objective To research the cause and countermeasure of complication of continued lumbar cerebrospinal fluid drainage (CLCFD) for the treatment of subarachnoid hemorrhage (SAH). Methods: Retrospectively analyzed the clinical material of 63 cases of patients with SAH who were hospitalized in department of neurosurgery from December 2010 to December 2011. All of them were be treated by CLCFD, and be observed the effect and complication of CLCFD. Result: The time of drainage were 1-29 days, average 5.87plusmn;1.04 days. Improvement of symptom: 43 cases were recovered excellently, 17 cases recovered partially, 3 cases were invalid. Complication: 22 cases had no complication, 1 cases has cerebral hernia,2 cases occurred rebleeding, 3 cases occurred hydrocephalus, 3 cases failed to intubate, 6 cases occurred intracranial hypotension.15 cases occurred blocking of the catheter, 6 cases made bold to draw the tube,5 cases occurred seepage, 6 cases were drainaged unfreely, 1 cases occurred subdural effus