腰大池置管引流脑脊液置换治疗蛛网膜下腔出血的并发症及处理

发布时间：2018-02-22 19:19

本文关键词： 蛛网膜下腔出血腰大池引流脑脊液并发症　出处：《中国现代医学杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的探讨腰大池置管引流脑脊液置换治疗蛛网膜下腔出血并发症出现的原因及处理对策。方法收集2014年12月-2015年12月河南省南阳市中心医院应用腰大池置管脑脊液置换治疗蛛网膜下腔出血63例病例资料,回顾分析所有患者腰大池置管引流效果及并发症发生情况。结果留管时间1~29 d,平均(5.87±1.04)d。症状改善情况:显效43例,有效17例,无效3例。并发症:无并发症22例,脑疝1例,再次脑出血2例,迟发型脑积水3例,置管失败3例,低颅压6例,堵管15例,自拔管6例,拔管后术口渗液5例,引流不畅6例,硬膜下积液1例,神经根痛3例。结论腰大池置管引流能快速引流血性脑脊液,缩短蛛网膜下腔出血患者的治疗时间,提高患者的恢复,并发症发生原因主要包括操作不当、置管不当、引流过度、患者依从性低等,临床工作中应根据不同并发症的发生原因采取相应处理措施,包括提高操作技能、注意控制引流量和引流时间、提高患者依从性等,以降低并发症的发生率。
[Abstract]:Objective to investigate the causes and treatment of complications of subarachnoid hemorrhage treated by cerebrospinal fluid replacement with drainage of lumbar cistern. Methods from December 2014 to December 2015 in Nanyang Central Hospital of Henan Province, the patients were collected and treated with lumbar cistern catheterization. The data of 63 cases of subarachnoid hemorrhage treated by liquid replacement. Results the drainage effect and complications of lumbar cistern were retrospectively analyzed. Results the mean duration of drainage was 5.87 卤1.04d. The symptoms were improved in 43 cases, effective in 17 cases, ineffective in 3 cases. Complications: no complication in 22 cases, cerebral hernia in 1 case. There were 2 cases of recurrent intracerebral hemorrhage, 3 cases of delayed hydrocephalus, 3 cases of failed catheterization, 6 cases of low intracranial pressure, 15 cases of obstruction, 6 cases of self-extubation, 5 cases of extubation, 6 cases of drainage, 1 case of subdural effusion. Conclusion the drainage of lumbar cistern can quickly drain the hemorrhagic cerebrospinal fluid, shorten the treatment time of the patients with subarachnoid hemorrhage, and improve the recovery of the patients. The main causes of complications include improper operation and improper catheterization. Patients with excessive drainage and low compliance should be treated according to the causes of different complications in clinical work, including improving operation skills, controlling drainage time and drainage flow, improving compliance of patients, etc. To reduce the incidence of complications.
【作者单位】：河南省南阳市中心医院神经外科二病区;
【分类号】：R743.35

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