颅内动脉瘤介入栓塞术后血性脑脊液引流方式对认知功能的影响  

Effect of different modes of hemorrhagic cerebrospinal fluid drainage on cognitive function after interventional embolization of intracranial aneurysm

作　　者：林超群 范学政 邱波 Lin Chaoqun;Fan Xuezheng;Qiu Bo(Department of Neurosurgery,University of Chinese Academy of Sciences Shenzhen Hospital(Guangming District),Shenzhen 518106,Guangdong,China)

机构地区：[1]中国科学院大学深圳医院(光明)神经外科,广东深圳518106

出　　处：《右江民族医学院学报》2021年第5期639-642,共4页Journal of Youjiang Medical University for Nationalities

摘　　要：目的比较分析反复腰椎穿刺与腰大池持续引流治疗动脉瘤性蛛网膜下腔出血两种方式对认知功能的影响。方法回顾性分析中国科学院大学深圳医院神经外科治疗2019年1月—2021年2月的动脉瘤性蛛网膜下腔出血59例,根据动脉瘤介入栓塞术后血性脑脊液引流方式,分为反复腰穿引流组28例和腰大池持续引流组31例。术前及术后一个月使用蒙特利尔认知评估量表对患者认知功能评分,得分27~30分为正常,<27分定义为认知功能障碍。结果术前两组患者认知障碍发生率分别为46.43%(13/28),32.26%(10/31),两组间比较差异无统计学意义(P>0.05)。术后1个月两组患者认知障碍发生率分别为35.71%(10/28)、12.90%(4/31),两组间比较差异有统计学意义(P<0.05)。结论与反复腰穿相比,腰大池持续引流治疗动脉瘤性蛛网膜下腔出血,可明显减少患者动脉瘤介入栓塞术后认知障碍的发生率。Objective To compare and analyze the effects of repeated lumbar puncture and continuous lumbar cistern drainage on cognitive function in the treatment of aneurysmal subarachnoid hemorrhage.Methods Fifty-nine cases of aneurysmal subarachnoid hemorrhage treated in Department of Neurosurgery,University of Chinese Academy of Sciences Shenzhen Hospital from January 2019 to February 2021 were retrospectively analyzed.According to the modes of hemorrhagic cerebrospinal fluid drainage after interventional embolization of intracranial aneurysm,59 cases were divided into repeated lumbar puncture drainage group(n=28)and continuous lumbar cistern drainage group(n=31).The Montreal Cognitive Assessment Scale was used to score the cognitive function of the patients before and one month after surgery.The score between 27~30 was normal,and the score<27 was defined as cognitive dysfunction.Results The incidence of cognitive impairment in two groups before surgery was 46.43%(13/28)and 32.26%(10/31),respectively,with no significant difference between two groups(P>0.05).At one month after surgery,the incidence of cognitive impairment in two groups was 35.71%(10/28)and 12.90%(4/31),respectively,and the difference between two groups was statistically significant(P<0.05).Conclusion Compared with repeated lumbar puncture,continuous lumbar cistern drainage for aneurysmal subarachnoid hemorrhage can significantly reduce the incidence of cognitive impairment after interventional embolization of intracranial aneurysm.

关 键 词：介入栓塞术 蒙特利尔认知评估量表 腰大池持续引流 腰椎穿刺术 认知功能障碍 

分 类 号：R749.1[医药卫生—神经病学与精神病学]