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早期清除血性脑脊液对重型脑外伤手术患者预后的影响

Effect of early clearance of bloody cerebrospinal fluid on the prognosis of patients with severe brain injury surgery

    摘要
  • 摘要:
      目的  探讨早期清除血性脑脊液对重型脑外伤手术患者预后的影响。
      方法  选择重型颅脑损伤手术患者70例, 分为2组。实验组40例术中使用足量明胶海绵及棉片保护术野及血肿腔，吸引器持续吸除血性液体，术后3~14 d内腰穿或腰池引流释放血性脑脊液。对照组30例给予常规手术及治疗。术后随访3个月，比较2组患者住院时间、脑积水发生情况以及格拉斯哥预后评分(GOS)。
      结果  实验组住院时间(17.5±4.8) d, 显著短于对照组(24.9±8.2) d (P < 0.05)。实验组发生脑积水1例，对照组发生脑积水5例，差异有统计学意义(P < 0.05)。实验组GOS评分显著优于对照组(P < 0.05)。
      结论  重型颅脑损伤患者行早期清除血性脑脊液，可以缩短住院时间，减少脑积水的发生，改善患者的预后。

     

    Abstract:
      Objective  To investigate effect of early clearance of bloody cerebrospinal fluid on the prognosis of patients with severe brain injury surgery.
      Methods  A total of 70 severe brain injury patients with surgery were selected and divided into two groups. Experimental group (n=40) was treated with sufficient gelatin sponge and cotton sheet to protect the operative field and hematoma cavity. The suction device was used to absorb blood fluid. The cerebrospinal fluid was released by lumbar puncture or lumbar cistern drainage within 3 to 14 days after operation. Control group (n=40) was given routine operation and treatment. After 3 months of follow-up, hospitalization time, hydrocephalus and Glasgow Outcome Score (GOS) were compared between the two groups.
      Results  The hospitalization time in the experimental group was (17.5±4.8) days, which was significantly shorter than (24.9±8.2) days in the control group (P < 0.05). There were 1 case of hydrocephalus in the experimental group and 5 cases of hydrocephalus in the control group, and there was significant difference between two groups (P < 0.05). The GOS score of the experimental group was significantly better than that of the control group (P < 0.05).
      Conclusion  Early clearance of blood cerebrospinal fluid in patients with severe craniocerebral injury can shorten hospitalization time, reduce the occurrence of hydrocephalus and improve the prognosis.

     

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