中华灾害救援医学2025，Vol.12Issue(9)：1049-1053,5.DOI:10.13919/j.issn.2095-6274.ZHJY202507007
侧脑室穿刺+腰大池置管脑脊液双向引流术治疗重症蛛网膜下腔出血的临床研究
Lateral Ventricular Puncture and Bidirectional Drainage of Cerebrospinal Fluid with Lumbar Cisterna Catheterization in the Treatment of Severe Subarachnoid Hemorrhage
摘要
Abstract
Objective To investigate the clinical value and safety of lateral ventricular puncture and two-way drainage of cerebrospinal fluid(CSF)in the treatment of severe subarachnoid hemorrhage.Methods The clinical data of 58 patients with severe subarachnoid hemorrhage who came to the Provincial Hospital of Fuzhou University from January 2023 to December 2024 were retrospectively analyzed.According to the drainage protocol,they were divided into control group(lateral ventricular puncture and drainage,n=29 cases)and observation group(lateral ventricular puncture and lumbar cisterna catheterization cerebrospinal fluid bidirectional drainage,n=29 cases).The clinical efficacy,neurological function,ability of daily living,levels of inflammatory factors,compli-cations and mortality were compared between the two groups.Results Compared with the control group,the total clinical response rate of the observation group was significantly higher[96.55%(28/29)vs 75.86%(22/29),P=0.022],the complication rate[6.90%(2/29)vs.27.59%(8/29),P=0.037]and the mortality rate[3.45%(1/29)vs.20.69%(6/29),P=0.044]in the observation group.Before treatment,there was no significant difference in NIHSS score(P=0.360)and ADL score(P=0.410)between the two groups.After treatment,the NIHSS score decreased and the ADL score increased in both groups.Compared with the control group,the NIHSS score in the observa-tion group was significantly lower(P<0.001),and the ADL score was significantly higher(P<0.001).Before treatment,there were no significant differences in hs-CRP(P=0.371),TNF-α(P=0.423)and IL-6(P=0.357)between the two groups.After treatment,the levels of inflamma-tory factors above the two groups decreased.Compared with the control group,the levels of hs-CRP(P<0.001),TNF-α(P<0.001)and IL-6(P<0.001)in the observation group were significantly lower.Conclusion In the treatment of patients with severe subarachnoid hemorrhage,lateral ventricular puncture and lumbar cisterna cath-eterization of cerebrospinal fluid bidirectional drainage have significant clinical effects,which can effectively im-prove patients'neurological function and daily living activities,reduce the level of inflammatory factors,reduce the risk of complications,and reduce the mortality of patients.关键词
重症蛛网膜下腔出血/侧脑室穿刺引流/腰大池置管脑脊液引流术Key words
Severe subarachnoid hemorrhage/Lateral ventricular puncture and drainage/Cerebrospinal fluid drainage with lumbar cistern分类
医药卫生引用本文复制引用
潘儒君,谢尧娟,张扬,黄绍崧,刘宇清,洪文瑶,廖正俭..侧脑室穿刺+腰大池置管脑脊液双向引流术治疗重症蛛网膜下腔出血的临床研究[J].中华灾害救援医学,2025,12(9):1049-1053,5.基金项目
福建省卫健委科技计划项目-面向农村和城市社区推广适宜技术项目(2021TG003) （2021TG003）
