腰大池置管引流联合尼莫地平对颅内动脉瘤介入治疗后脑血管痉挛的作用  

Effect on cerebral vasospasm after operation interventional therapy in intracranial aneurysms by lumbar cistern drainage combined with nimodipine

作　　者：彭华[1] 邱俊[1] 

机构地区：[1]四川宜宾市第二人民医院神经外科,宜宾644000

出　　处：《中国实用神经疾病杂志》2014年第24期10-11,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的观察腰大池置管引流联合尼莫地平对颅内动脉瘤介入治疗术后脑血管痉挛(CVS)的作用。方法选取我院收治的69例Hunt-Hess分级相同的颅内动脉瘤破裂出血患者,均给予血管内介入治疗,术后随机分为2组,观察组35例行腰大池置管持续引流,对照组34例行间断腰穿释放脑脊液(CSF),2组均经深静脉尼莫地平持续泵入,观察2组患者大脑中动脉血流速度(VMCA)、临床神经功能评分(CSS)及并发症发生情况。结果观察组并发症发生率明显低于对照组,CVS发生率低,且治疗后脑脊液(CSF)RBC数目以及压力明显较对照组下降,差异有统计学意义(P<0.05);术后14d观察组神经功能缺损程度评分减少程度优于对照组(P<0.05)。结论早期持续腰大池引流能有效降低颅内动脉瘤破裂出血介入治疗术后CVS的发生率,患者神经功能恢复良好,预后明显改善。Objective To observe the effect on cerebral vasospasm of after operation of endovascular intracranial aneurysms therapy by lumbar cistern drainage combined with nimodipine.Methods 69 cases of ruptured intracranial aneurysm（the same Hunt-Hess grade）from our hospital were selected,all were treated with endovascular therapy,and after operation,all were randomly divided into 2groups,observation group（n=35）were given lumbar cistern continuous drainage,control group（n=34）were given intermittent lumbar puncture cerebrospinal fluid（CSF）,and all were given deep vein nimodipine continuous infusion.Middle cerebral artery blood flow velocity（VMCA）,neurologic function score（CSS）and the incidence of complications between two groups were observed.Results The complications incidence rate of observation group is significantly lower than control group,the CVS incidence rate is lower,and red blood cell（RBC）and pressure in cerebrospinal fluid（CSF）of posttherapy are lower than control group（P〈0.05）,after operation for 14 d,the reduction in neural function defect score of observation group is better than control group（P〈0.05）.Conclusion Early continuous lumbar cistern drainage can effectively reduce the CVS incidence,keep good nerve function recovery and improve prognosis of interventional post-therapy in intracranial aneurysm rupture.

关 键 词：颅内动脉瘤 脑血管痉挛(CVS) 腰大池置管引流 腰椎穿刺 血管内栓塞 尼莫地平 

分 类 号：R739.41[医药卫生—肿瘤]