Roitberg B Z, Khan N, Alp M S, Hersonskey T, Charbel F T, Ausman J I
Department of Neurosurgery (M/C799), University of Illinois at Chicago, 912 S. Wood Street, Chicago, IL 60612, USA.
Br J Neurosurg. 2001 Aug;15(4):324-7. doi: 10.1080/02688690120072478.
The purpose of this retrospective study was to evaluate the results of external ventricular drain (EVD) placement for the management of hydrocephalus. We present our experience with 103 consecutive cases over one year, 56 of which had subarachnoid hemorrhage (SAH). Short tunnel ventriculostomy was performed at the bedside in the neurosurgical intensive care unit (NSICU), using sterile technique. Long-term care included meticulous site care by a dedicated NSICU nurse, daily cultures and prophylactic antibiotics. The average duration of EVD was 10.7 days (range 1-28 days). There was one case of positive cerebrospinal fluid (CSF) culture. Additional complications included one small intraparenchymal hematoma and two cases of EVD disconnection. No patient died form EVD-associated complications. No rebleed from aneurysmal SAH was seen. There was no correlation between the duration of EVD and infection. We conclude that placement of short EVD in the NSICU is safe and can be maintained for the required duration of treatment with minimum infection rate.
这项回顾性研究的目的是评估外置脑室引流（EVD）治疗脑积水的效果。我们展示了我们在一年多时间里连续103例病例的经验，其中56例患有蛛网膜下腔出血（SAH）。在神经外科重症监护病房（NSICU）床边采用无菌技术进行短隧道脑室造瘘术。长期护理包括由专门的NSICU护士进行细致的置管部位护理、每日培养和预防性使用抗生素。EVD的平均持续时间为10.7天（范围1 - 28天）。有1例脑脊液（CSF）培养呈阳性。其他并发症包括1例小的脑实质内血肿和2例EVD断开连接。没有患者死于EVD相关并发症。未观察到动脉瘤性SAH再出血。EVD持续时间与感染之间无相关性。我们得出结论，在NSICU放置短EVD是安全的，并且可以在所需的治疗持续时间内维持，感染率最低。
