动脉瘤性蛛网膜下腔出血栓塞术后早期连续腰椎穿刺治疗的疗效  

Efficacy of early consecutive lumbar puncture treatment in aneurysmal subarachnoid hemorrhage after embolization

作　　者：韩金涛[1] 傅军[1] 李选[1] 王昌明[1] 翟国钧[1] 

机构地区：[1]北京大学第三医院介入血管外科,北京100191

出　　处：《北京大学学报（医学版）》2013年第4期639-642,共4页Journal of Peking University:Health Sciences

摘　　要：目的:总结腰椎穿刺对于动脉瘤性蛛网膜下腔出血栓塞术后治疗的指导性意义。方法:北京大学第三医院介入血管外科自2002年12月至2011年9月收治破裂颅内动脉瘤行动脉瘤栓塞术患者43例,术后第1日起每日行腰椎穿刺治疗,测脑脊液压力,缓慢引流脑脊液。依腰椎穿刺结果决定血压的控制、脱水及补液治疗方案。结果:死亡2例,存活的41例患者中仅1例患者出现脑血管痉挛、脑梗死及梗阻性脑积水,经脑室腹腔分流术,1例梗阻性脑积水自行缓解,其余39例患者恢复良好,平均随访(26.0±5.8)个月,无新发神经系统症状。结论:破裂颅内动脉瘤栓塞术后早期腰椎穿刺在动脉瘤性蛛网膜下腔出血的术后治疗中有重要意义。Objective：To summarize the significance of lumbar punctures in remedy for aneurysmal subarachnoid hemorrhage（aSAH） after embolization.Methods： From December 2002 to September 2011,43 cases of aSAH underwent aneurysm embolization at department of interventional radiology and vascular surgery,Peking University Third Hospital.After the embolization,consecutive lumbar punctures were undertaken everyday,by which we measured proper cerebrospinal fluid pressure and slow drainage of cerebrospinal fluid.In accordance with the lumbar puncture results we determined the control of blood pressure,dehydration and rehydration therapy procedures.Results： Two patients died.Only one patient in the 41 cases of the survived patients developed cerebral vasospasm,cerebral infarction and obstructive hydrocephalus,but by ventriculo-peritoneal shunt,obstructive hydrocephalus was relieved.The remaining 39 patients recovered well.After the mean follow-up of（26.0±5.8） months,no new neurological symptoms were found.Conclusion： Early consecutive lumbar puncture treatment in ASH after embolization is significant.

关 键 词：脊椎穿刺 蛛网膜下腔出血 颅内动脉瘤 治疗结果 

分 类 号：R654.3[医药卫生—外科学]