腰大池置管持续引流防治动脉瘤性蛛网膜下腔出血并发脑积水的效果观察  

Observation on the Effect of Continuous Lumbar Cisterna Drainage in the Treatment of Hydrocephalus Caused by Aneurysmal Subarachnoid Hemorrhage

作　　者：王东兵[1] WANG Dong-bing.(Department of Surgery, Luohe Third People＇s Hospital, Luohe 462000, Henan Province, Chin)

机构地区：[1]河南省漯河市第三人民医院外二科,河南漯河462000

出　　处：《罕少疾病杂志》2017年第4期29-30,37,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的观察腰大池置管持续引流防治动脉瘤性蛛网膜下腔出血并发脑积水的效果。方法选取2013年5月至2015年4月我院收治的动脉瘤性蛛网膜下腔出血(SAH)患者88例为研究对象,采用随机数表法分为观察组和对照组各44例,对照组术后行腰穿刺引流,观察组术后实施腰大池持续引流,对比两组治疗总有效率,同时记录其治疗前后脑血流速度(Vm)、疼痛视觉模拟评分(VAS)、格拉斯哥评分(GOS),并观察术后脑积水、脑血管痉挛等并发症发生率。结果观察组治疗有效率81.82%明显高于对照组61.36%(P<0.05);观察组治疗后Vm(129.35±1.74)cm/s、VAS评分(3.26±1.29)分均低于对照组(P<0.05),GOS评分(4.39±0.14)分高于对照组(P<0.05);观察组术后脑积水、脑血管痉挛发生率(9.09%、15.91%)较对照组(27.27%、36.36%)低(P<0.05)。结论腰大池置管持续引流对动脉瘤性蛛网膜下腔出血治疗效果优于腰椎穿刺引流,同时可有效防治脑积水等并发症,值得在临床推广开应用。Objective To observe the effect of continuous lumbar cisterna drainage in the treatment of hydrocephalus caused by aneurysmal subarachnoid hemorrhage. Met：hods A total of 88 patients with aneurysmal subarachnoid hemorrhage（SAH） from May 2013 to April 2015 in our hospital were taken as the clinical research objects, and they were divided into observation group （44 cases） and control group （44 cases） randomly. Patients in the control group were given lumbar puncture drainage, the other patients in the observation group were given continuous lumbar cisterna drainage. The cerebral blood flow velocity （Vm）,visual analogue pain scale （VAS） and Glasgow score （GOS） before and after treatment were recorded, the postoperative complications as hydrocephalus and cerebral vasospasm were observed, and the total effective rates in the two groups were compared. Results The total effective rate in the observation group was 81.82% which was significantly higher than that in the control group 61.36%（P〈0.05）. The Vm and VAS in the observationgroup were respectively （129.35±1.74）cm/s and （3.26±1.29） which were lower than those in the control group（P〈0.05）. The GOS in the observation group was （4.39±0.14） which was significantly higher than that in the control group （P〈0.05）. The incidence rates of postoperative hydrocephalus and cerebral vasospasm in the observation group were respectively 9.09% and 15.91% which were lower than those in the control group 27.27% and 36.36%（P〈0.05）. Conclusion Continuous lumbar cisterna drainage, has better effect in the treatment of aneurysmal subarachnoid hemorrhage, and can effectively prevent hydrocephalus and other complications. Thus, it is worthy of clinical application.

关 键 词：腰大池置管持续引流 动脉瘤性蛛网膜下腔出血 脑积水 

分 类 号：R619[医药卫生—外科学] R681.5[医药卫生—临床医学]