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目的探讨腰大池持续引流脑脊液加鞘内注入地塞米松治疗重度颅脑损伤的临床疗效。方法对于GCS评分3~6分的重型颅脑损伤的88例病人,随机分为实验组和对照组。常规抗炎、脱水、止血、对症或手术治疗,并在入院或开颅后行ICP、CPP监护;实验组加做持续腰大池引流脑脊液术并鞘内注入地塞米松:5mg+NS10ml每日2次。结果实验组颅内压下降明显,并发症少,良好38.6%,中残31.8%,重残11.4%,植物生存9.1%,死亡9.1%。结论持续腰大池引流脑脊液加鞘内注入地塞米松治疗重型颅脑损伤,有效地减轻脑水肿,降低颅内压,减少并发症,提高抢救的成功率和改善患者的生存质量。
Objective To investigate the clinical efficacy of continuous drainage of cerebrospinal fluid and intrathecal dexamethasone in treatment of severe craniocerebral injury. Methods 88 patients with severe craniocerebral injury with GCS score of 3 to 6 were randomly divided into experimental group and control group. Routine anti-inflammatory, dehydration, hemostasis, symptomatic or surgical treatment, and ICP or CPP monitoring after admission or craniotomy; experimental group plus continuous lumbar drainage drainage of cerebrospinal fluid and intrathecal dexamethasone: 5mg + NS10ml daily 2 Times. Results The intracranial pressure of the experimental group decreased obviously with less complications, with a good 38.6%, a moderate residual of 31.8%, a severe residual of 11.4%, a plant survival of 9.1% and a death of 9.1%. Conclusion Continuous lumbar drainage with cerebrospinal fluid and intrathecal injection of dexamethasone can effectively reduce cerebral edema, reduce intracranial pressure, reduce complications, improve the success rate of rescue and improve the quality of life of patients with severe craniocerebral injury.