开颅术后辅助腰大池持续引流治疗重型颅脑损伤.docVIP

开颅术后辅助腰大池持续引流治疗重型颅脑损伤 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：开颅术后辅助腰大池持续引流治疗重型颅脑损伤 1 1 资料与方法 3 文2：开颅术后辅助腰大池持续引流治疗重型颅脑损伤 5 1 资料与方法 6 2 结果 8 3 讨论 9 参考文摘引言： 11 原创性声明（模板） 12 文章致谢（模板） 12 正文 开颅术后辅助腰大池持续引流治疗重型颅脑损伤 文1：开颅术后辅助腰大池持续引流治疗重型颅脑损伤 【Abstract】 Objective To discuss the mechanism and effect of treatment of drainage subarachnoid lumbar space continuously with severe craniocerebral trauma after craniotomy. Methods There were 116 cases of severe craniocerebral trauma postoperatively，we divided therapeutic group and contrast group randomly. We used continuous drainage subarachnoid lumbar space the next day postoperatively in therapeutic group，and in contrast group we used lumbar puncture at the same time.Results The postoperative amount of RBC less than 100×106 /L( RBC 100×106 / L )was (5.0d，2.3d) and (7.1d，3.5d) in therapeutic group and contrast group respectively(P0.0l).The total protein in cerebrospinal fluid postoperative less than 0.8g/L(TP0. 8g/ L)was(8.0±3.6d) and (11.2±4.4d) in therapeutic group and contrast group，respectively(P0.0l).The average intracranial pressure，the usage and dose of mannitol，hydrocephalus，cerebral infarction，and fatality rate were statisticsly significance in treatment group and contrast group.Conclusion The method of continuous drainage subarachnoid lumbar space with severe craniocerebral trauma after craniotomy could cleaned bloody cerebrospinal fluid more quicker， decreasing intracranial pressure，decreasing the usage of mannitol，decreasing complication and fatality rate， improving prognosis. 【Key words】 severe craniocerebral trauma： bloody cerebrospinal fluid：intracranial pressure： drainage subarachnoid lumbar space 重型颅脑伤GCS 3～8分的死亡率在35%左右［1］。开颅血肿清除大骨瓣减压术及按Mashall降颅压措施［2］，颅内压仍然显著升高者，治疗上十分困难。重型颅脑损伤常合并外伤性蛛网膜下腔出血，开颅术后创面渗血流散到蛛网膜下腔，两种原因所产生的血性脑脊液引起脑血管痉挛，导致脑缺血、脑水肿而造成恶性高颅压，以及血性脑脊液导致的脑梗死、脑积水等并发症，进一步增加了治疗的难度。我科于2003年6月~2005年7月对58例重型颅脑损伤病人开颅术后辅助腰大池持续引流治疗，取得满意效果，现总结分析如下。 1 资料与方法 1.1 一般资料 本组116例患者中男84例，女32例；年龄15~60岁，平均33岁。