摘要：

目的: 探讨长程皮下通道脑室外引流术（LTEVD）应用于神经外科的可行性。方法: 纳入2020年6月至2022年8月在广西壮族自治区南宁市第二人民医院行脑室外引流术的187例患者，分别行LTEVD（82例）和短程皮下通道脑室外引流术（STEVD，105例），详细记录术后引流管留置时间，以及引流管移位、引流管堵塞、脑脊液漏、继发性颅内感染和引流管留置天数继发性颅内感染发生率。结果: LTEVD组引流管留置时间长于STEVD组[23.00（14.00，33.50）d对7.00（5.00，10.00）d；Z =-10.126，P = 0.000]，引流管留置天数继发性颅内感染发生率低于STEVD组[1.92‰（4/2087）对16.35‰（13/795）；χ² = 187.000，P = 0.000]。结论: LTEVD可显著延长引流管留置时间，引流管留置天数继发性颅内感染发生率可明确引流管留置时间对继发性颅内感染的影响。

关键词: 神经外科手术, 引流术, 中枢神经系统感染, 脑脊髓液

Abstract:

Objective: To evaluate the feasibility of long - tunnelled external ventricular drainage (LTEVD) in neurosurgery. Methods: A total of 187 patients who underwent external ventricular drainage in The Second Nanning People's Hospital from June 2020 to August 2022 were included. They were respectively treated with LTEVD (LTEVD group, n = 82) and short - tunnelled external ventricular drainage (STEVD group, n = 105). The indwelling time of postoperative drainage tube were recorded in detail. Drainage tube displacement, drainage tube blockage, cerebrospinal fluid leakage, and the incidence of secondary intracranial infection, as well as the incidence of secondary intracranial infection during drainage tube indwelling days. Results: The comparison of safety between 2 groups showed that the drainage tube indwelling time in LTEVD group was significantly longer than that in STEVD group [23.00 (14.00, 33.50) d vs. 7.00 (5.00, 10.00) d; Z =-10.126, P = 0.000], and the secondary intracranial infection rate during drainage tube indwelling days was lower than that in STEVD group [1.92‰ (4/2087) vs. 16.35‰ (13/795); χ² = 187.000, P = 0.000]. Conclusions: LTEVD can significantly prolong the indewelling time of drainage tube, the incidence of secondary intracranial infection during drainage tube indwelling days can clarify the effect of drainage tube indwelling time on the incidence of secondary intracranial infection.

Key words: Neurosurgical procedures, Drainage, Central nervous system infections, Cerebrospinal fluid