中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2012年
6期
833-835
,共3页
方乃成%赵明%杜国森%王马军%金星火%潘柏林%韦超%徐铁峰%王宁%王超
方迺成%趙明%杜國森%王馬軍%金星火%潘柏林%韋超%徐鐵峰%王寧%王超
방내성%조명%두국삼%왕마군%금성화%반백림%위초%서철봉%왕저%왕초
血肿,硬膜下,颅内%脑室造口术%引流术
血腫,硬膜下,顱內%腦室造口術%引流術
혈종,경막하,로내%뇌실조구술%인류술
Hematoma,subdural,intracranial%Ventriculostomy%Drainage
目的 比较采用不同引流管与置管方法治疗脑室内铸型血肿的疗效.方法 按随机原则,将83例脑室内铸型血肿患者分成观察组48例,采用弹头形大口径多孔引流管侧脑室联合置管引流术；对照组35例,采用常规应用的脑室外引流管侧脑室前角置管引流术,术后对两组病例脑室内血肿清除率和治疗结果进行监测和分析.结果 术后＜24h、24～72 h、＞72 h等不同时间点,观察组脑室内血肿清除率分别为27.1％(13/48)、50.0％( 24/48)、14.6％( 7/48),与对照组的5.7％( 2/35)、17.1％ (6/35)、48.6％( 17/35)等差异均有统计学意义(x2 =6.2425、9.4678、11.3757,均P＜0.01).治疗后,观察组ADL分级Ⅰ级47.9％明显高于对照组的20.0％(x2=6.8347,P＜0.01),观察组病死率12.5％,低于对照组的37.1％(x2=6.9636,P＜0.01).结论 弹头形大口径多孔引流管能避免引流管堵塞,侧脑室联合置管术有利于脑室内血肿的引流性治疗,在脑室内铸型血肿患者中应用能显著提高治疗效果.
目的 比較採用不同引流管與置管方法治療腦室內鑄型血腫的療效.方法 按隨機原則,將83例腦室內鑄型血腫患者分成觀察組48例,採用彈頭形大口徑多孔引流管側腦室聯閤置管引流術；對照組35例,採用常規應用的腦室外引流管側腦室前角置管引流術,術後對兩組病例腦室內血腫清除率和治療結果進行鑑測和分析.結果 術後＜24h、24～72 h、＞72 h等不同時間點,觀察組腦室內血腫清除率分彆為27.1％(13/48)、50.0％( 24/48)、14.6％( 7/48),與對照組的5.7％( 2/35)、17.1％ (6/35)、48.6％( 17/35)等差異均有統計學意義(x2 =6.2425、9.4678、11.3757,均P＜0.01).治療後,觀察組ADL分級Ⅰ級47.9％明顯高于對照組的20.0％(x2=6.8347,P＜0.01),觀察組病死率12.5％,低于對照組的37.1％(x2=6.9636,P＜0.01).結論 彈頭形大口徑多孔引流管能避免引流管堵塞,側腦室聯閤置管術有利于腦室內血腫的引流性治療,在腦室內鑄型血腫患者中應用能顯著提高治療效果.
목적 비교채용불동인류관여치관방법치료뇌실내주형혈종적료효.방법 안수궤원칙,장83례뇌실내주형혈종환자분성관찰조48례,채용탄두형대구경다공인류관측뇌실연합치관인류술；대조조35례,채용상규응용적뇌실외인류관측뇌실전각치관인류술,술후대량조병례뇌실내혈종청제솔화치료결과진행감측화분석.결과 술후＜24h、24～72 h、＞72 h등불동시간점,관찰조뇌실내혈종청제솔분별위27.1％(13/48)、50.0％( 24/48)、14.6％( 7/48),여대조조적5.7％( 2/35)、17.1％ (6/35)、48.6％( 17/35)등차이균유통계학의의(x2 =6.2425、9.4678、11.3757,균P＜0.01).치료후,관찰조ADL분급Ⅰ급47.9％명현고우대조조적20.0％(x2=6.8347,P＜0.01),관찰조병사솔12.5％,저우대조조적37.1％(x2=6.9636,P＜0.01).결론 탄두형대구경다공인류관능피면인류관도새,측뇌실연합치관술유리우뇌실내혈종적인류성치료,재뇌실내주형혈종환자중응용능현저제고치료효과.
Objective To explore the effect of different methods of drainage tube and catheter drainage in the treatment of intraventricular hematoma.Methods The analysis was conducted in 83 cases,who were randomly divided into two groups,the treatment group with 48 cases adopting lateral venticle catheterization combined with bulletshaped tube,and the control group with 35 cases adopting conventional catheterization.The contrasted study was conducted on the clearance rate of cerebroventricular hematoma and the effect of the different drainages.Results The clearance rate in treatment group was 27.1％ ( 13/48 ),50.0％ (24/48),14.6％ (7/48),at the time of ＜ 24h,24 ～72h,＞ 72h after the operation,and 5.7 ％ ( 2/35 ),17.1％ ( 6/35 ),48.6％ ( 17/35 ) in the control group.It showed statistical significance(x2 =6.2425,9.4678,11.3757,all P ＜0.01 ).The cases with type Ⅰ of ADL stage in treatment group (47.9％)were more than control group( x2 =6.8347,P ＜0.01 ).The morbidity in treatment group was 12.5％,which was lower than control group( x2 =6.9636,P ＜0.01 ).Conclusion The lateral venticle catheterization drainage combined with bullet-shaped tube could avoid the obstruction,reduce the morbidity,and improve the therapeutic effect.
