摘要
目的探讨腰大池持续脑脊液引流术（CLCFD）对重型颅脑损伤术后脑脊液漏患者的治疗效果。方法纳入2014年1月至2014年12月青海省人民医院重症医学科收治的52例重型颅脑损伤术后脑脊液漏患者。根据治疗方法的不同将52例患者分为常规腰穿组（26例）和CLCFD组（26例）。比较两组患者的脑脊液漏停止时间、14d临床治愈率以及颅内感染率。结果CLCFD组和常规腰穿组的脑脊液漏停止时间分别为（6．3±1．4）d和（12．2±2．1）d，两组差异有统计学意义（P〈0．001）。CLCFD组和常规腰穿组的14d临床治愈率分别为92％（24／26）和77％（20／26），两组差异有统计学意义（P〈0．001）。CLCFD组中有1例（4％）出现颅内感染，常规腰穿组中8例（31％）出现颅内感染，CLCFD组的颅内感染发生率明显低于常规腰穿组（P〈0．001）。结论采用早期CLCFD治疗重型颅脑损伤术后脑脊液漏能够缩短患者的脑脊液漏持续时间、提高14d临床治愈率并降低颅内感染发生率，其临床疗效优于常规腰穿释放脑脊液。
Objective To investigate the treatment effect of continuous lumbar cerebrospinal fluid drainage （CLCFD） on patients with cerebrospinal fluid leakage after severe craniocerebral injury operation. Methods Fifty-two patients with postoperative cerebrospinal fluid leakage following severe traumatic brain injury admitted to the Intensive Care Unit, Qinghai Provincial Peopleg Hospital from January 2014 to December 2014 were enrolled. According to the different treatment methods, the 52 patients were divided into either a routine lumbar puncture group （ n = 26） or a CLCFD group （ n = 26）. The differences of the stop time of cerebrospinal fluid leakage, the clinical cure rate within 14 d, and the intracranial infection rate were compared in patients between the 2 groups. Results The stop time of cerebrospinal fluid leakage of the CLCFD group and the routine lumbar puncture group was 6.3±1.4 d and 12.2±2. 1 d respectively （ P 〈 0. 001 ）. There was significant difference between the 2 groups. The cure rates of the CLCFD group and the routine lumbar puncture group within 14 d were 92% （24/26） and 77% （20/26） respectively. There was significant difference between the 2 groups （P 〈 0.001 ）. One patient （4%） had intraeranial infection in the CLCFD group, and 8 （31%） had intracranial infection in the routine lumbar puncture group. The incidence of intracranial infection of the CLCFD group was significantly lower than that of the routine lumbar puncture group （P 〈 0. 001 ）. Conclusions Using early CLCFD for the treatment of postoperative cerebrospinal fluid leakage following severe traumatic brain injury may shorten the duration of cerebrospinal fluid leakage in patients, improve the clinical cure rate within 14 d, and decrease the incidence of intracranial infection. Its clinical efficacy is significantly superior to releasing eerebrospinal fluid of conventional lumbar puncture.
出处
《中华神经外科杂志》
CSCD
北大核心
2016年第6期593-595,共3页
Chinese Journal of Neurosurgery
关键词
颅脑损伤
腰大池引流
脑脊液漏
Craniocerebral trauma
Lumbar eerebrospinal fluid drainage
Cerebrospinal fluid leakage
