吴胜青 曾振坤 黄建顺 伍海青 李景东 黄威 吴伟源

【摘要】 目的：探讨改良皮下隧道式腰大池外引流置管和常规腰大池置管法在临床中的效果。方法：选取2018年5月-2019年3月笔者所在医院收治的需留置腰大池外引流管的60例患者为研究对象，使用简单随机法分为观察组和对照组，每组30例。观察组行改良皮下隧道式腰大池外引流置管法，对照组行常规腰大池置管法，比较两组并发症发生率、导管留置时间、预防性抗生素使用率。结果：观察组术后并发症发生率为6.67%，低于对照组的26.67%（P<0.05）;观察组导管留置时间长于对照组，术后换药次数少于对照组，预防性抗生素使用率低于对照组（P<0.05）。結论：改良皮下隧道式腰大池外引流置管能有效降低患者术后并发症发生率，延长导管留置时间，降低预防性抗生素使用率，减轻医务人员工作量。

【关键词】 改良皮下隧道式 腰大池外引流置管 并发症 抗生素

doi：10.14033/j.cnki.cfmr.2020.20.013 文献标识码 B 文章编号 1674-6805（2020）20-00-03

Comparison of the Clinical Effect of the Improved Subcutaneous Tunnel Drainage Tube of Lumbar Cistern and Conventional Lumbar Cistern Catheterization/WU Shengqing， ZENG Zhenkun， HUANG Jianshun， WU Haiqing， LI Jingdong， HUANG Wei， WU Weiyuan. //Chinese and Foreign Medical Research， 2020， 18（20）： -38

[Abstract] Objective： To explore the clinical effect of improved subcutaneous tunnel drainage tube of lumbar cistern and conventional lumbar cistern catheterization. Method： A total of 60 patients who requiring indwelling of drainage tube of the lumbar cistern admitted to our hospital from May 2018 to March 2019 were selected as the research objects. They were divided into the observation group and the control group by simple randomized method， with 30 cases in each group. The observation group was treated with improved subcutaneous tunnel drainage tube of lumbar cistern， while the control group was treated with conventional lumbar cistern catheterization. The incidence of complications， time of catheter retention and use rate of prophylactic antibiotics were compared between the two groups. Result： The incidence of postoperative complications in the observation group was 6.67%， which was lower than 26.67% of the control group （P<0.05）. The time of catheter retention in the observation group was longer than that of the control group， and the frequency of dressing change was less than that of the control group， and the use rate of prophylactic antibiotics was lower than that of the control group （P<0.05）. Conclusion： Improved subcutaneous tunnel drainage tube of lumbar cistern can effectively reduce the incidence of postoperative complications， prolong the time of catheter retention， reduce the use rate of prophylactic antibiotics， and reduce the workload of medical staff.

[Key words] Improved subcutaneous tunnel Drainage tube of lumbar cistern Complications Antibiotics

First-authors address： Shijie Hospital of Dongguan City， Dongguan 523290， China

颅腔内容纳着血液、脑脊液及脑组织，其中脑脊液是由脑室内的脉络丛分泌产生，经脑室、脑池及蛛网膜下腔循环后由蛛网膜颗粒吸收的动态循环过程[1]。在病理情况下，将血性或炎症性脑脊液引流出体外，可有效减轻炎症因子等对颅脑的继发性损伤[2]。腰大池外引流术是现临床上引流脑脊液的主要方式，但其在引流过程中易受骶曲的影响而使导管移位，且皮下潜行距离短易形成窦道导致穿刺点脑脊液渗漏等[3]。基于此，笔者将传统腰大池外引流置管法改良，增加导管皮下潜行距离，在隧道出口予以缝扎固定引流管，并将其在临床上试行，观察可行性。

1 资料与方法

1.1 一般资料

選取2018年5月-2019年3月笔者所在医院收治的需留置腰大池外引流管的60例患者为研究对象。纳入标准：（1）年龄≥18岁;（2）颅脑CT提示蛛网膜下腔出血或脑室积血，脑室系统扩大，脑室额角周围有间质水肿带，脑室径/双顶径>25%。排……