早期联合腰大池引流治疗脑室内及蛛网膜下血肿的临床效果观察

刘颖斌 张丽兴 彭俊隆

[摘要]目的 研究脑室内及蛛网膜下血肿患者采取早期腰大池引流治疗的临床效果。方法 选取我院2015年3月～2017年2月收治的106例脑室内及蛛网膜下血肿患者作为研究对象，按照随机数字表法分为研究组与对照组，每组各53例。对照组采取常规治疗，研究组在对照组基础上早期采取腰大池引流治疗，观察所有患者治疗后的并发症发生率以及生活质量评分，比较两组患者的临床治疗效果。结果 研究组患者的治疗总有效率（92.45%）高于对照组（81.13%），差异有统计学意义（P<0.05）；研究组患者继发性脑积水、脑血管痉挛、癫痫以及脑梗死的发生率低于对照组，差异有统计学意义（P<0.05）。两组患者治疗前的生活质量评分比较，差异无统计学意义（P>0.05），研究组治疗后的生活质量评分高于对照组，差异有统计学意义（P<0.05）。结论 脑室内及蛛网膜下血肿患者在常规治疗基础上早期采取腰大池引流效果较好，可有效防止继发性脑积水，进一步提高治疗效果，安全性高，改善生存质量，为预后提供保障。

[关键词]效果观察；腰大池引流；继发性脑积水；血肿

[中图分类号] R743.34 [文献标识码] A [文章编号] 1674-4721（2018）5（a）-0064-03

[Abstract]Objective To study the clinical effect of early lumbar cistern drainage in patients with intraventricular and subarachnoid hematomas.Methods A total of 106 patients with intraventricular and subarachnoid hematoma treated in our hospital from March 2015 to February 2017 were selected as research subjects.According to random table method，they were evenly divided into research group and control group，53 cases in each group.The control group was treated with routine treatment.In the research group，on the basis of the control group，early application of lumbar cistern drainage was used.The incidence of post-treatment complications and quality of life score were observed in all patients，and the clinical efficacy of the two groups was compared.Results The total effective rate in the research group （92.45%） was higher than that in the control group （81.13%），the difference was statistically significant （P<0.05）.The incidence of secondary hydrocephalus，cerebral vasospasm，epilepsy，and cerebral infarction in the research group were lower than those in the control group，the differences were statistically significant （P<0.05）.There was no significant difference in quality of life scores between the two groups before treatment （P>0.05）.After therapy，the quality of life score in the research group was higher than that of the control group，the difference was statistically significant （P<0.05）.Conclusion For intraventricular and subarachnoid hematoma patients，on the basis of routine treatment，early application of lumbar cistern drainage obtains a favorable effect.It can effectively prevent secondary hydrocephalus，improve the therapeutic effect in high safety，ameliorate the quality of life，and guarantee prognosis.

[Key words]Effect observation；Lumbar cistern drainage；Secondary hydrocephalus；Hematoma

腦室内及蛛网膜下血肿属于神经科的常见危重症，具有起病较急、病情发展较快等特点，主要表现为头痛剧烈、呕吐以及意识障碍等，部分患者可能伴有烦躁不安、幻觉以及谵妄等，严重者甚至抽搐、昏迷，威胁其生命安全[1]。临床上常采取手术方式进行治疗，虽然取得一定的应用价值，但术后并发症较多，患者极易出现继发性脑积水，降低治疗效果，延长治疗时间，导致预后较差[2-3]。若能够早期采取有效干预，可预防继发性脑积水，改善生活质量，促进病情快速稳定，因此如何选择疗效确切且安全性高的治疗方式成为医疗界关注的重点[4]。本文选取106例脑室内及蛛网膜下血肿患者作为研究对象，旨在探讨早期腰大池引流在脑室内及蛛网膜下血肿患者治疗中的应用价值，现报道如下。……