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持续腰大池引流技术在神经外科中的临床应用
Clinical Application and Analysis of Lumbar Continuous Drainage of Fluid in Neurosurgery
【作者】 洪亚军;
【导师】 钱志远;
【作者基本信息】 苏州大学 , 神经外科学, 2011, 硕士
【摘要】 目的:探讨持续腰大池脑脊液引流技术在神经外科应用的临床价值。方法:回顾性分析2010年1月2011年2月间我科83例患者进行持续腰大池脑脊液引流治疗的临床资料,其中颅内感染24例,蛛网膜下腔出血26例,交通性脑积水10例,脑室积血9例,颅内占位12例,单纯脑脊液鼻漏2例。结果:持续腰大池脑脊液引流治疗24例颅内感染中,22例治愈,2例死亡;26例蛛网膜下腔出血患者治愈24例,2例死亡;10例脑积水患者,治愈8例,2例好转后行V-P分流术;9例脑室积血患者中1例好转,其余8例均治愈;12例颅内占位中,2例死亡,10例治愈。2例单纯脑脊液鼻漏患者均治愈。83例患者未发生因引流继发的颅内感染及脑疝等严重并发症,6例死亡均与置管引流无关。结论:持续腰大池脑脊液引流技术是一种安全、有效、微创的方法,可用于治疗颅内感染、蛛网膜下腔出血、交通性脑积水等神经外科常见病症。第二部分持续腰大池引流技术在锁孔手术围手术期中的应用31例分析目的:探讨持续腰大池脑脊液引流在神经外科锁孔手术围手术期中的临床应用价值。方法:回顾性分析2010年1月2011年2月间我科31例锁孔手术患者进行持续腰大池脑脊液引流治疗的临床资料,其中颅内动脉瘤21例,颅内占位10例。结果:持续腰大池脑脊液引流的31例锁孔手术患者中,21例颅内动脉瘤患者治愈20例,1例自动出院后死亡;10例颅内占位患者治愈9例,1例自动出院后死亡。31例患者未发生因引流继发的颅内感染及脑疝等严重并发症,2例死亡均与置管引流无关。结论:持续腰大池脑脊液引流技术是一种安全、有效、微创的方法,选择应用于锁孔手术围手术期很有价值。
【Abstract】 Objective: To investigate the clinical value of the application of lumbar continuous drainage of fluid in neurosurgery.Methods: Retrospective analysis the clinical data of 83 cases which performed lumbar continuous drainage of fluid in our department from January 2010 to February 2011. including intracranial infection 24 cases, subarachnoid hemorrhage 26 cases, communicating hydrocephalus 10 cases, ventricle hematoma 9 cases, mass in intracranial 12 cases, cerebrospinal rhinorrhea 2 cases.Results: 22 cases were cured in the 24 cases of intracranial infection, 2 cases were dead. 24 cases were cured in the 26 cases of subarachnoid hemorrhage, 2 cases were dead. 8 cases were cured in the 10 cases of communicating hydrocephalus, and 2 cases were performed V-P shunt after improving. 8 cases were cured in the 9 cases of ventricle hematoma, 1 case discharged after improving. 2 cases were dead of the mass in intracranial 12 cases, and the 10 cases were cured. The 2 cases of cerebrospinal rhinorrhea were all cured. There is no severe complications ,such as intracranial infection and brain hernia, caused by lumbar continuous drainage of fluid. The 6 dead cases were independence with the lumbar continuous drainage of fluid.Conclusions: The lumbar continuous drainage of fluid is a safe、effective and micro-damage method. It can be used to treat many common diseases in neurosurgery, such as intracranial infection, subarachnoid hemorrhage, communicating hydrocephalus and so on.Objective: To investigate the clinical value of the application of lumbar continuous drainage of fluid in keyhole approach operations.Methods: Retrospective analysis the clinical data of 31 keyhole approach operations which performed lumbar continuous drainage of fluid in our department from January 2010 to February 2011.including intracranial aneurysm 21 cases, mass in intracranial 10 cases.Results : 1 case of intracranial aneurysms died after discharge,and the left 20 cases were cured. 1 case of mass in intracranial died and the others were cured. There is no severe complications, such as intracranial infection and brain hernia, caused by lumbar continuous drainage of fluid. The 2 dead cases were independence with the lumbar continuous drainage of fluid.Conclusions: The lumbar continuous drainage of fluid is a safe, effective and micro-damage method. It is valuable to be used in the keyhole approach operations .