摘要
目的探讨自发行颅内出血患者开颅术后腰大池持续引流过度现象、预防措施及脑脊液安全引流量。方法回顾性分析117例自发性颅内出血开颅术后并行腰大池置管引流的患者临床资料,发现101例患者未出现腰大池引流过度（B组）,16例患者出现引流过度症状（A组）,比较两组患者在第1、2、3、4、5、6、7天平均脑脊液引流量的差异。结果 116例出现引流过度的患者中,第1-7天出现的例数分别是1例、1例、6例、3例、3例、1例、1例。2比较两组患者第1-7天的脑脊液引流量,第1、2、6、7天两组患者脑脊液的引流量没有统计学差异（P〉0.05）;第3、4、5天两组患者的脑脊液引流量有统计学差异（P〈0.05）。两组7天的平均脑脊液引流量有统计学差异（P〈0.05）。3未发生引流过度症状患者的99%单侧医学参考值范围上限是196.33 ml。结论 1患者在一周的腰大池引流过程都有可能出现引流过度出现相关临床症状,主要集中在第3-5天发生。2腰大池脑脊液引流每日不超过196.33 ml,可明显降低患者出现引流过度症状的发生率。
Objective To investigate the phenomenon of excessive lumbar drainage after craniotomy,related preventive measures,and the safe volume of cerebrospinal fluid drainage in patients with spontaneous intracerebral hemorrhage. Methods The clinical data of117 patients with spontaneous intracerebral hemorrhage who underwent craniotomy and lumbar drainage were analyzed retrospectively.The results showed that 101 patients among them did not experience excessive lumbar drainage（ group B）,and 16 patients experienced excessive drainage（ group A）. The average volume of cerebrospinal fluid drainage was compared between the two groups on days 1,2,3,4,5,6,and 7. Results Among the 16 patients experiencing excessive drainage,the numbers of patients experiencing excessive drainage on days 1- 7 were 1,1,6,3,3,1,and 1,respectively. There were no significant differences in the volume of cerebrospinal fluid drainage on days 1,2,6,and 7 between the two groups（ P 〉0. 05）,while there were significant differences in the volume of cerebrospinal fluid drainage on days 3,4,and 5（ P 〈0. 05）. The two groups had a significant difference in the average volume of cerebrospinal fluid drainage through days 1- 7（ P 〈0. 05）. The unilateral upper limit of 99% medical reference range for the patients without excessive drainage was 196. 33 ml. Conclusions The patients may experience excessive drainage and related clinical symptoms during the 1-week lumbar drainage procedure,which mainly occurs on days 3- 5. The daily volume of cerebrospinal fluid drainage should not exceed 196. 33 ml,and this limit can significantly reduce the incidence of symptoms related to excessive lumbar drainage.
出处
《国际神经病学神经外科学杂志》
北大核心
2015年第6期519-522,共4页
Journal of International Neurology and Neurosurgery
关键词
腰大池引流
脑脊液
颅内出血
Lumbar drainage
Cerebrospinal fluid
Intracerebral hemorrhage
