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目的探讨脑脊液持续置换治疗重型颅脑损伤伴脑疝患者,以降低重残率和病死率。方法先于开颅对侧侧脑室额角置双腔引流管,再采用标准外伤大骨瓣开颅术清除血肿并去除骨瓣减压;术后一腔持续引流脑脊液,另一腔按3～8 ml/h持续向脑室内泵入0.9%氯化钠溶液,3～5 d后,改为双腔持续引流脑脊液,7～12 d(平均10 d),拔除双腔引流管。结果本组19例,经治疗后16例存活,其中14例恢复良好,2例重残;3例死亡。结论脑脊液持续置换治疗重型颅脑损伤伴脑疝患者,能降低重残率和病死率。
Objective To investigate the continuous replacement of cerebrospinal fluid in patients with severe craniocerebral injury with cerebral hernia to reduce severe disability and mortality. Methods The contralateral lateral cerebral ventricle was placed in front of the craniotomy with double-lumen drainage tube, followed by a standard trauma craniotomy to remove the hematoma and remove the decompression of the bone flap. One postoperative continuous drainage of cerebrospinal fluid and the other in 3-8 ml / h, 0.9% sodium chloride solution was continuously pumped into the ventricles. After 3 to 5 days, the cerebrospinal fluid was continuously infused into the double-lumen cavity for 7 to 12 days (average 10 days), and the double-lumen drainage tube was removed. Results The group of 19 cases, after treatment, 16 cases survived, 14 cases recovered well, 2 cases of severe disability; 3 patients died. Conclusion Continuous replacement of cerebrospinal fluid in severe craniocerebral injury patients with cerebral hernia can reduce severe disability and mortality.