脑脊液压力监测在早期腰大池外引流治疗重型脑室出血中临床应用.docVIP

脑脊液压力监测在早期腰大池外引流治疗重型脑室出血中临床应用 　　【摘要】 目的：探讨侧脑室脑脊液（CSF）压力监测在早期腰大池外引流（LD）治疗重型脑室出血（IVH）中的应用及效果。方法：选取2011年3月-2014年9月笔者所在医院收治的65例重型IVH患者，其中37例（对照组）采用侧脑室外引流（EVD）并脑室内纤溶治疗（IVF），28例（观察组）在侧脑室CSF压力监测下早期联合应用LD。比较两组尿激酶使用总量、CSF持续外引流时间、引流相关并发症（脑疝、颅内再出血、颅内积气、硬膜下积液、颅内感染、穿刺点CSF漏、脑积水）发生率及预后。结果：观察组尿激酶使用总量、CSF持续外引流时间均少于对照组，引流相关并发症发生率低于对照组，差异均有统计学意义（P0.05）。结论：侧脑室CSF压力监测下早期联合应用LD治疗重型IVH安全、可行，可显著减少尿激酶用量、缩短CSF持续外引流时间、降低引流相关并发症发生率。 　　【关键词】 脑室出血； 脑室外引流； 腰大池外引流； 脑脊液压力监测； 预后 　　中图分类号 R743.34 文献标识码 A 文章编号 1674-6805（2016）4-0011-02 　　Clinical Application of Cerebrospinal Fluid Pressure Monitoring in Severe Intraventricular Hemorrhage Treated with Early Lumbar Drainage/DONG Guang-yu，WANG Xin-jun，LIAO Yi-fan，et al.//Chinese and Foreign Medical Research，2016，14（4）：11-12 　　【Abstract】 Objective：To investigate the clinical effect of CSF pressure monitoring in severe intraventricular hemorrhage（IVH） treated with early lumbar drainage（LD）.Method：65 IVH patients in our hospital from March 2011 to September 2014 were treated with external ventricular drainage（EVD） and intraventricular fibrinolysis（IVF），they were divided into the control group（37 cases， received EVD and IVF） and the observation group（28 cases， received EVD， IVF， early LD under CSF pressure monitoring）.The urokinase and CSF continuous drainage time， drainage related complications（cerebral hernia， intracranial hemorrhage， intracranial pneumatosis， subdural effusion， intracranial infection， puncture point of CSF leakage， hydrocephalus） incidence and prognosis of the two groups were compared.Result：The total urokinase dosage， the time of extracorporeal CSF drainage and the rate of complications were significantly lower in the observation group than that in the control group（P0.05）.Conclusion：Early combined application of CSF in the treatment of in the early stage of the combined application of LD in the treatment of severe IVH is feasible， which can significantly reduce the dosage of urokinase， shorten the duration of CSF， and reduce the inc