脑室出血患者经脑室外引流联合腰大池引流治疗效果及预后观察

Observation on the Therapeutic Effect and Prognosis of External Ventricular Drainage Combined with Lumbar Drainage in Patients with Intraventricular Hemorrhage

摘要: 目的：探讨联合采用脑室外引流术及腰大池引流与单纯实施脑室外引流术对脑室出血的临床疗效及对预后影响。本研究将我院2019年2月至2023年6月确诊的150例脑室出血患者分为两组。对比分析了两组的情况：脑室穿刺置管外引流术被用于对照组的治疗，而治疗组使用了脑室外引流术和腰大池置管引流术的结合方式进行治疗，总结比对两组的治疗效果和预后状况。治疗组患者治疗后良好、中等和差的比例分别为48、24和3；而对照组分别为34、22和19。治疗组的疗效显著优于对照组，差异在统计学上具有意义(x² = 12.255, P < 0.01)。治疗组病人的血肿清除过程用时约6.3 ± 1.4小时，而他们的住院时长则大约为17.9 ± 1.9小时，明显短于对照组的12.3 ± 1.6小时和31.3 ± 2.9小时，两组比较的差异均具有统计学意义(t值分别为22.854、22.012，P均<0.01)。治疗组中，中枢发热、肺炎、再出血、脑积水、应激性消化道出血的发生率分别为4、5、1、1、8，显著低于对照组的12、16、7、6、20。两组之间的比较差异均具有统计学意义(x²值分别为5.565、6.689、3.449、4.158、7.314，P均<0.01)。我们可以得出结论，脑室外引流术和腰大池置管引流术的联合应用在治疗脑室出血方面显示出优越的疗效和安全性，预后状况让人满意，也较少出现并发症，整体上提高了患者的生活质量。

Abstract: Objective: To explore the clinical efficacy and prognosis of combined external ventricular drainage and lumbar drainage versus external ventricular drainage alone for intraventricular hemorrhage. This study divided 150 patients with intraventricular hemorrhage diagnosed in our hospital from February 2019 to June 2023 into two groups. Comparative analysis of the situation of the two groups: ventricular puncture and external drainage was used in the treatment of the control group, while the treatment group used a combination of external ventricular drainage and lumbar catheter drainage. The treatment effects and prognosis of the two groups are summarized and compared. The proportions of patients in the treatment group who were good, moderate and poor after treatment were 48, 24 and 3 respectively; while those in the control group were 34, 22 and 19 respectively. The therapeutic effect of the treatment group was significantly better than that of the control group, and the difference was statistically significant (x² = 12.255, P < 0.01). The hematoma removal process for patients in the treatment group took about 6.3 ± 1.4 hours, and their length of hospitalization was about 17.9 ± 1.9 hours, which was significantly shorter than the 12.3 ± 1.6 hours and 31.3 ± 2.9 hours in the control group. There were differences between the two groups. Statistical significance (t values are 22.854 and 22.012 respectively, P < 0.01). In the treatment group, the incidence rates of central fever, pneumonia, rebleeding, hydrocephalus, and stress-induced gastrointestinal bleeding were 4, 5, 1, 1, and 8 respectively, which were significantly lower than those in the control group (12, 16, 7, 6 and 20). The differences between the two groups were statistically significant (x² values were 5.565, 6.689, 3.449, 4.158, and 7.314 respectively, P < 0.01). We can conclude that the combined application of external ventricular drainage and lumbar catheter drainage shows superior efficacy and safety in the treatment of intraventricular hemorrhage, with satisfactory prognosis and fewer complications, which overall improves the patient’s quality of life.