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脑室外引流联合腰大池引流治疗自发性脑室出血的临床研究
Clinical Study of External Ventricular Drainage Combined with Lumbar Cistern Drainage in the Treatment of Spontaneous Intra-Ventricular Hemorrhage

DOI: 10.12677/ACRS.2021.102005, PP. 29-33

Keywords: 自发性脑室出血，颅内压，脑室外引流，腰椎穿刺，预后
Spontaneous Intra-Ventricular Hemorrhage, Intracranial Pressure, EVD, Lumber Puncture, Prognosis

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Abstract:

通过对比研究脑室外引流联合腰大池引流(EVD-LP)和单纯脑室外引流(EVD)治疗重度自发性脑室出血患者的疗效，为自发性脑室出血患者的治疗提供参考。前瞻性分析收治的重度自发性脑室出血患者52例，按治疗方法分为EVD治疗组(13例)和EVD-LP治疗组(39例)，EVD治疗组将脑室型颅内压探头放在积血脑室内，引流并监测“颅内压”的变化。EVD-LP诊疗组在EVD治疗组基础上，待复查头部CT显示第三脑室、第四脑室及室间孔及中脑导水管无完全性梗阻性积血后，置入腰大池外引流管引流，比较分析两组患者脑室引流管留置时间、血肿清除时间和术后患者1个月、3个月的日常生活能力(ADL)量表评分来评价患者预后情况。结果显示，EVD-LP组患者无严重并发症出现，两组在良好预后人数(χ2 = 1.926, P > 0.05)、引流管留置时间(χ2 = 0.188, P > 0.05)、脑室内血肿完全清除时间(χ2 = 1.067, P > 0.05)无统计学差异，EVD-LP组患者的3月后良好(ADL 1~3分)预后率82%显著高于EVD组54%。本研究表明，EVD-LP治疗重度自发性脑室出血安全有效，无严重并发症出现，能显著提高患者3月良好预后率。

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