颅内压监测下侧脑室穿刺脑室外引流术治疗脑室内出血的临床效果

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摘要目的探索颅内压监测下侧脑室穿刺脑室外引流术治疗脑室内出血的临床效果。方法选取2017年7月～2018年12月广东省揭阳市人民医院神经外一科收治的70 例脑室内出血患者作为研究对象，采用数据库随机分组法将其分为观察组和对照组，每组各35 例。观察组患者采用颅内压监测下侧脑室穿刺脑室外引流术治疗，对照组患者采用常规脑室穿刺引流治疗。比较两组患者的甘露醇使用量、甘露醇使用时间、并发症总发生率；比较两组患者术后第1、3 天的血肿排空率；比较两组患者的血肿残留量；比较两组患者术前及术后第3、7 天的格拉斯哥昏迷指数（GCS）。结果观察组患者的血肿残留量、甘露醇使用量少于对照组，差异有统计学意义（P＜0.05）。观察组患者的甘露醇使用时间短于对照组，差异有统计学意义（P＜0.05）。观察组患者的并发症总发生率低于对照组，差异有统计学意义（P＜0.05）。观察组患者术后第1、3 天的血肿排空率高于对照组，差异有统计学意义（P＜0.05）。观察组患者术后第3、7 天的GCS 评分高于对照组，差异有统计学意义（P＜0.05）。结论对脑室内出血患者实施颅内压监测下侧脑室穿刺脑室外引流术治疗效果显著。

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	杨克
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关键词 ：颅内压监测, 侧脑室穿刺脑室外引流术, 脑室内出血, 格拉斯哥昏迷指数, 并发症, 血肿排空率

Abstract：Objective To explore the clinical effect of intracranial pressure monitoring of lateral ventricle puncture for extraventricular drainage in the treatment of intraventricular hemorrhage. Methods Seventy-seven patients with intraventricular hemorrhage from the First Department of Neurosurgery in Jieyang People′s Hospital of Guangdong Province from July 2017 to December 2018 were selected as subjects. The patients were divided into observation group and control group by database random grouping method, 35 cases in each group. Patients in the observation group were treated with intracranial pressure monitoring of the lower ventricle puncture for extraventricular drainage, and patients in the control group were treated with conventional ventricle puncture drainage. The Mannitol dosage, Mannitol use time and the total incidence of complications were compared between the two groups. The hematoma emptying rates on the first and third day after operation were compared between the two groups. The hematoma residues of the two groups were compared. The Glasgow coma indexes (GCS) before and at 3 and 7 days after operation of the two groups were compared. Results The residual amount of hematoma and the Mannitol dosage in the observation group were lower than those in the control group, the differences were statistically significant (P＜0.05). The Mannitol use time in the observation group was shorter than that of the control group, the difference was statistically significant (P＜0.05). The overall incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant (P＜0.05). The hematoma emptying rates of the observation group on the first and third day after operation were higher than those of the control group, and the differences were statistically significant (P＜0.05). The GCS scores at 3 and 7 days after operation in the observation group were higher than those of the control group, with statistically significant differences (P＜0.05). Conclusion The intracranial pressure monitoring of intracranial pressure in patients with intraventricular hemorrhage is effective in the treatment of lateral ventricle puncture.

Key words： Intracranial pressure monitoring Lateral ventricle puncture for extraventricular drainage Intraventricular hemorrhage Glasgow coma index Complications Hematoma emptying rate

引用本文:

杨克; 蔡少明; 邱平华; 谢乐辉; 李汉城. 颅内压监测下侧脑室穿刺脑室外引流术治疗脑室内出血的临床效果[J]. 中国当代医药, 2020, 27(7): 61-64.
YANG Ke; CAI Shao-ming; QIU Ping-hua; XIE Le-hui ; LI Han-cheng. Clinical effect of intracranial pressure monitoring of lateral ventricle puncture for extraventricular drainage in the treatment of intraventricular hemorrhage. 中国当代医药, 2020, 27(7): 61-64.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I7/61

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