高分级后交通动脉瘤患者术后行腰大池置管持续引流术的临床效果  

Clinical Effect of Continuous Lumbar Drainage in Patients with High Grade Posterior Communicating Aneurysm

作　　者：程伟[1] 仲瑶[1] 杨少春[1] 邹连生[1] 娄建云[1] 刘德华[1] 廖伟[1] 傅煌武 CHENG Wei;ZHONG Yao;YANG Shaochun;ZOU Liansheng;LOU Jianyun;LIU Dehua;LIAO Wei;FU Huangwu(The First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,China;不详)

机构地区：[1]江西省赣南医学院第一附属医院,江西赣州341000 [2]江西省大余县人民医院

出　　处：《中国医学创新》2020年第28期144-147,共4页Medical Innovation of China

基　　金：赣州市科技计划项目(赣市财教字[2017]8号)。

摘　　要：目的:探讨高分级后交通动脉瘤患者术后行腰大池置管持续引流术的临床效果。方法:回顾性分析2016年10月-2018年8月赣南医学院第一附属医院神经外科收治的52例高分级后交通动脉瘤患者的临床诊治资料,患者均待病情好转后再行颅内动脉瘤夹闭术,并进行一般常规治疗,26例患者术后行常规腰椎穿刺术引流设为对照组,26例患者术后行腰大池置管持续引流术设为观察组。比较两组治疗效果、症状改善情况、并发症发生情况、治疗后的GOS评分及治疗前后大脑中动脉流速(Vm)变化情况。结果:观察组临床治疗总有效率为76.92%,明显高于对照组的42.31%,差异有统计学意义(P<0.05)。观察组颅内压下降至正常的时间及认知功能转好时间分别为(13.16±2.86)、(11.75±2.65)d,均明显短于对照组的(17.48±2.69)、(14.08±2.47)d,差异均有统计学意义(P<0.05)。观察组患者脑积水及脑血管痉挛的发生率均低于对照组,差异均有统计学意义(P<0.05);两组脑梗死、再出血的发生率比较,差异均无统计学意义(P>0.05)。治疗后,观察组GOS评分高于对照组(P<0.05)。两组治疗后的Vm均明显低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论:采用腰大池置管持续引流术可更有效缩短恢复时间,改善预后情况,提高治疗效果。Objective:To investigate the clinical efficacy of continuous lumbar drainage in patients with high grade posterior communicating aneurysm.Method:The clinical diagnosis and treatment data of 52 patients with high-grade posterior communication aneurysm admitted to the department of neurosurgery,the First Affiliated Hospital of Gannan Medical University from October 2016 to August 2018 were retrospectively analyzed,all patients were treated with intracranial aneurysm clipping after their condition improved,and received general and conventional treatment,26 patients underwent conventional lumbar puncture drainage after surgery and were set as the control group,while 26 patients underwent continuous lumbar drainage after surgery were set as the observation group.The treatment effect,symptoms improvement,complications,GOS score after treatment and Vm changes before and after treatment were compared between the two groups.Result:The total effective rate was 76.92% in the observation group,which was significantly higher than 42.31% in the control group,the difference was statistically significant (P<0.05).The time for the reduction of intracranial pressure to normal and the time for improvement of cognitive function in the observation group were (13.16±2.86),(11.75±2.65) d,which were significantly shorter than (17.48±2.69),(14.08±2.47) d in the control group,the differences were statistically significant (P<0.05).The incidence of hydrocephalus and cerebral vasospasm in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05);there were no significant differences in the incidence of cerebral infarction and rebleeding between the two groups (P>0.05).After treatment,the GOS score of the observation group was higher than that of the control group (P<0.05).The Vm of both groups after treatment were significantly lower than those before treatment,and the observation group was lower than that of the control group,the difference was statistically significant (P<

关 键 词：腰大池置管持续引流术 高分级 后交通动脉瘤 

分 类 号：R651.12[医药卫生—外科学]