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目的:分析重型颅脑外伤并蛛网膜下腔出血术后持续腰大池引流疗效观察。方法:选取韶关市始兴县人民医院2014年5月至2016年8月76例重型颅脑外伤并蛛网膜下腔出血患者,采用随机分配的方式分为对照组和观察组各38例。对照组患者采用单纯开颅血肿清除及去骨瓣减压术进行治疗,观察组患者则在此基础上通过持续腰大池引流进行治疗,对两组患者进行长期随访,对比患者的治疗效果。结果:观察组脑血管痉挛、脑积水、脑梗死、癫痫的几率明显低于对照组(P<0.05),继发颅内感染的几率比对照组高,但差异无统计学意义(P>0.05);总有效率观察组明显高于对照组(P<0.05);同时,观察组的预后也明显优于对照组,差异具有统计学意义(P<0.05)。结论:重型颅脑外伤并蛛网膜下腔出血通过持续腰大池引流能够降低患者的病死率与致残率,降低并发症发生几率,提高预后,但同时也可能引发继发性颅内感染,因此要根据患者的实际情况,合理选择。
Objective: To analyze the curative effect of continuous lumbar drainage after severe craniocerebral injury and subarachnoid hemorrhage. Methods: A total of 76 patients with severe traumatic brain injury and subarachnoid hemorrhage from May 2014 to August 2016 in Shaoxing Shixing People’s Hospital were selected and randomly divided into control group and observation group, with 38 cases in each group. Patients in the control group were treated with simple craniotomy and craniectomy for decompression. The patients in the observation group were treated with continuous drainage of the lumbar drainage on the basis of this. Patients in both groups were followed up for a long time to compare the therapeutic effect of the patients. Results: The incidences of cerebral vasospasm, hydrocephalus, cerebral infarction and epilepsy in the observation group were significantly lower than those in the control group (P <0.05), and the incidence of secondary intracranial infection was higher than that in the control group (P> 0.05). The total effective rate in the observation group was significantly higher than that in the control group (P <0.05). At the same time, the prognosis of the observation group was also significantly better than that of the control group. The difference was statistically significant (P <0.05). CONCLUSIONS: Severe craniocerebral trauma and subarachnoid hemorrhage can reduce the mortality and morbidity of patients by continuous lumbar drainage, reduce the incidence of complications and improve the prognosis, but may also cause secondary intracranial infection. Therefore, According to the actual situation of patients, a reasonable choice.