摘要目的 探讨万向调节支架在脑出血脑室引流术后患者中的应用效果。方法 回顾性分析2019年4月至2021年1月在萍乡矿业集团有限责任公司总医院介入科行脑室引流术的108 例脑出血患者,按治疗方法不同分为观察组和对照组,每组54 例,对照组采用传统方法固定引流袋,观察组采用万向调节支架固定引流袋,观察调节精准度及节约时间、松脱率、术后不良反应总发生率。结果 观察组引流量少于对照组,置管时间短于对照组,而调节精准度和视觉模拟评分法(VAS)评分低于对照组(P<0.05);观察组术后12、24、72 h 颅内压水平均低于对照组(P<0.05);与术后12 h 和24 h 比,两组患者术后72 h 的颅内压均降低(P<0.05);观察组不良反应总发生率低于对照组(P<0.05)。结论 采用万向调节支架固定脑室引流管,有利于缩短置管时间,减轻疼痛,降低颅内压,提高置管安全性,可在临床推广应用。
Abstract:Objective To investigate the effect of universal regulating stent in patients with cerebral hemorrhage after ventricular drainage.Methods 108 cases of cerebral hemorrhage patients who were received ventricular drainage in Intervention Department of General Hospital of Pingxiang Mining Group Co., Ltd.from April 2019 to January 2021 were retrospectively analysised.They were randomly divided into observation group and control group, with 54 cases in each group.In the observation group, the drainage bag was fixed with a universal regulating stent, and the adjustment accuracy, time saving, release rate and total postoperative rebleeding rate were observed.Results The drainage volume,catheterization time, adjustment accuracy and visual analogue scale (VAS) score in the observation group were lower than those in the control group (P<0.05); the levels of intracranial pressure in the observation group were lower than those in the control group at 12, 24 and 72 h after surgery (P<0.05); compared with 12 h and 24 h after operation, the intracranial pressure of the two groups decreased at 72 h (P<0.05); the total incidence of adverse reactions in the observation group was lower than that in the control group (P<0.05).Conclusion The niversal regulating stent to fix the ventricular drainage tube is beneficial to shorten the time of catheter placement, relieve pain, reduce intracranial pressure, improve the safety of catheter placement, and can be popularized in clinical application.
李小兰. 万向调节支架在脑出血脑室引流术后患者中的应用[J]. 中国当代医药, 2021, 28(29): 215-217.
LI Xiao-lan. Application of universal regulating stent in patients with cerebral hemorrhage after ventricular drainage. 中国当代医药, 2021, 28(29): 215-217.
Xia L,Han Q,Ni XY,et al.Different Techniques of Minimally Invasive Craniopuncture for the Treatment of Hypertensive Intracerebral Hemorrhage[J].World Neurosurg,2019,126:e888-e894.
Fried HI,Nathan BR,Rowe AS,et al.The Insertion and Management of External Ventricular Drains:An Evidence-Based Consensus Statement:A Statement for Healthcare Professionals from the Neurocritical Care Society[J].Neurocrit Care,2016,24(1):61-81.
Roach J,Gaastra B,Bulters D,et al.Safety,Accuracy, and Cost Effectiveness of Bedside Bolt External Ventricular Drains (EVDs) in Comparison with Tunneled EVDs Inserted in Theaters[J].World Neurosurg,2019,125:e473-e478.
[15]
Rao SS,Chung DY,Wolcott Z,et al.Intermittent CSF drainage and rapid EVD weaning approach after subarachnoid hemorrhage:Association with fewer VP shunts and shorter length of stay[J].J Neurosurg,2019,132(5):1583-1588.