ObjectiveTo explore the clinical application of comprehensive stroke units in treating patients of hemorrhagic stroke after craniotomy. MethodsWe randomly divided the 288 postoperative patients with hemorrhagic stroke treated from January 2010 to December 2013 into two groups:stroke unit group and conventional treatment group. Then we observed and compared their clinical indicators after they received different therapeutic regimens. ResultsDifferences in the national Institude of Health Stroke Scale (4.6±3.2 vs. 7.3±4.1), activities of daily living (89.3±15.6 vs. 72.5±20.3), and duration of hospital stays[(23.3±5.2) vs. (32.5±8.3) days] were significant (P<0.05) on discharge day. The infection rate during hospitalization, the scores of Glasgow outcome scale three months after leaving hospital between the stroke unit group and the conventional treatment group were statistically significant (P<0.05). There was no remarkable difference in the average cost of hospitalization between the two groups (P>0.05). ConclusionComprehensive stroke unit treatment can significantly reduce the disability rate for postoperative patients with hemorrhagic stroke, shorten the average length of stay at the hospital, save the health care resources, and improve the patients' ability to return to society as well as the satisfaction of family members.
方法 2008年9月-2009年11月，将20例颅脑外伤后颅内感染患者分为脑脊液外引流组和抗生素组各10例，外引流组进行持续腰池置管脑脊液外引流，定期取引流脑脊液进行常规和生化检查；抗生素组采用静脉抗生素治疗。对两组颅内感染情况进行对比分析。 结果 外引流组经持续腰池置管脑脊液外引流治疗后，颅内感染临床症状明显缓解，脑脊液有核细胞数和脑脊液微量蛋白含量显著降低、脑脊液葡萄糖和氯化物浓度升高（Plt;0.05）。治疗10 d后，外引流组体温、脑脊液有核细胞数、脑脊液微量蛋白含量、脑脊液葡萄糖和氯化物浓度的改善程度明显优于抗生素组（Plt;0.05）。 结论 持续腰池置管脑脊液外引流治疗颅内感染具有安全性高、操作简便、观察颅内感染情况方便的优点，可作为颅内感染可靠治疗手段。【Abstract】 Objective To observe the efficacy of continuous lumbar drainage of cerebrospinal fluid via a lumbar catheter in treating intracranial infection. Methods From September 2008 to November 2009, 20 patients with intracranial infection after head trauma were enrolled in this study. Ten of them, classified as the external drainage group, sustained continuous external lumbar drainage of cerebrospinal fluid. The cerebrospinal fluid was obtained regularly for routine and biochemical examination. The other 10 patients were categorized as the antibiotics group. They only accepted intravenous antibiotic therapy. Results For the patients in the external drainage goup, after continuous external lumbar drainage of cerebrospinal fluid, their clinical symptoms of intracranial infection were significantly alleviated and the number of nucleated cells and protein content in the cerebrospinal fluid decreased significantly, while the glucose and chloride concentrations increased significantly (Plt;0.05). After 10 days of treatment, the patients in the external drainage group were superior to those in the antibiotics group in improvement of the body temperature, the number of nucleated cells and protein content, glucose and chloride concentrations in the cerebrospinal fluid (Plt;0.05). Conclusion Continuous lumbar drainage of cerebrospinal fluid is simple and safe. It provides an easy way of monitoring the intracranial infection and can be a reliable treatment.