探讨腰大池置管外引流术中应用改良皮下隧道式置管方法的优点及临床运用。

选择自2015年3月到2016年12月东莞市石碣医院及南方医科大学附属珠江医院神经外科收治的无颅内感染且有留置腰大池外引流管适应征患者92例为研究对象，随机分成2组（各46例）进行回顾性临床分析，采用改良皮下隧道式腰大池外引流置管方法的病例为观察组，采用常规腰大池外引流置管的病例为对照组，观察并对比2组在颅内感染、穿刺点脑脊液漏、导管移位、非计划拔管、未按规定时间换药等方面的差异。

观察组46例运用改良皮下隧道式置管方法置管的病例中，在穿刺点脑脊液漏、导管移位及未按规定时间换药等方面的发生率均明显低于对照组，差异有统计学意义（P<0.05）。而在颅内感染及非计划拔管的方面观察组发生率为2.2%（1/46），对照组发生率为8.7%（4/46），虽然差异无统计学意义（P>0.05），但在数据方面看，仍有发生率减少的优势。

运用改良皮下隧道式腰大池外引流置管方法与常规腰大池置管方法相比，在减少置管后所观察的5种并发症发生率方面优点突出，改良方法在临床工作中可行性大。

To explore the advantages and clinical application of modified subcutaneous tunnel placement method in external drainage of lumbar cistern.

Ninety-two patients with no intracranial infection and indications of indwelling drainage tube outside the lumbar cistern, admitted to Department of Neurosurgery of Shijie Hospital of Dongguan City and Zhujiang Hospital of Southern Medical University from March 2015 to December 2016, were randomly divided into 2 groups. The cases of modified subcutaneous tunnel external drainage were used as observation group, and the control group was treated with external drainage of lumbar cistern, Observe and compare the two groups in intracranial infection, cerebrospinal fluid leakage, catheter displacement, unplanned extubation, not in accordance with the provisions of the time and other aspects of change.

The observation group of 46 cases using the modified subcutaneous tunnel catheter catheterization method in the cases of cerebrospinal fluid leakage in the point of puncture, catheter displacement and not according to the provisions of the incidence of dressing and other aspects of the time were significantly lower than control group, the difference was statistically significant (P<0.05). In the intracranial infection and unplanned extubation in the observation group the incidence rate was 2.2% (1/46), the control group the incidence rate was 8.7% (4/46), although no statistically significant difference (P>0.05), but in terms of data, there are still advantages in reducing the incidence of.

Compared with the conventional method of lumbar cistern catheterization, the modified subcutaneous tunnel external drainage method was superior to the conventional method in the management of 5 complications, so the improved method is feasible in clinical work.