持续腰大池引流配合超早期显微手术在颅内动脉瘤破裂治疗中的临床应用  

Clinical Application of Continuous Lumbar Cistern Drainage Combined with Ultra-early Microsurgery in the Treatment of Intracranial Aneurysm Rupture

作　　者：袁新春[1] 董伟[1] 刘学永[1] YUAN Xinchun;DONG Wei;LIU Xueyong(Neurosurgery Department of Peixian County People's Hospital,Peixian,Jiangsu Province,221600 China)

机构地区：[1]江苏省沛县人民医院神经外科,江苏沛县221600

出　　处：《中外医疗》2022年第3期84-87,共4页China & Foreign Medical Treatment

摘　　要：目的探讨颅内动脉瘤破裂患者行超早期显微手术配合持续腰大池引流治疗的临床效果、安全性及应用价值。方法简单随机选取2017年1月—2021年6月沛县人民医院收治颅内动脉瘤破裂患者50例,以双盲法进行随机分组,对照组患者接受开颅收束配合常规腰穿治疗,观察组患者接受超早期显微手术配合持续腰大池引流治疗,对比两组患者术后不同时间脑脊液压力及红细胞数量变化,治疗前后神经功能及Barthel指数变化,术后并发症情况。结果观察组患者术后3 d监测脑脊液压力(235.09±10.02)mmH_(2)O、6 d监测脑脊液压力(210.28±11.05)mmH_(2)O、9 d监测脑脊液压力(185.44±10.02)mmH_(2)O、12 d监测脑脊液压力(165.58±10.33)mmH_(2)O均明显低于对照组,差异有统计学意义(t=6.401、9.694、10.633、6.277,P<0.05)。术后3 d观察组患者神经功能评分(15.23±1.06)分明显低于对照组,Barthel指数(75.59±5.33)分高于对照组,差异有统计学意义(t=25.972、12.335,P<0.05)。观察组患者术后并发症总发生率4.00%明显低于对照组,差异有统计学意义(χ^(2)=4.878,P<0.05)。结论颅内动脉瘤破裂患者接受超早期显微手术配合持续腰大池引流治疗具有确切疗效,能够有效降低患者脑脊液压力,促进神经功能恢复,减少术后并发症,值得临床运用推广。Objective To explore the clinical effect,safety and application value of ultra-early microsurgery in patients with ruptured intracranial aneurysm combined with continuous lumbar cistern drainage.Methods From January 2017 to June 2021,50 cases of patients with ruptured intracranial aneurysms which were admitted to the Pei County People's Hospital were simple randomly selected.Randomization was carried out by double-blind method.Patients in the control group received craniotomy and conventional lumbar puncture treatment,and patients in the observation group received ultra-early microsurgery combined with continuous lumbar drainage treatment.The changes in cerebrospinal fluid pressure and the number of red blood cells at different times after surgery,the changes in neurological function and Barthel index before and after treatment,and the postoperative complications between the two groups of patients were compared.Results In the observation group,the cerebrospinal fluid pressure was monitored for 3 d(235.09±10.02)mmH_(2)O,6 d(210.28±11.05)mmH_(2)O,9 d(185.44±10.02)mmH_(2)O,and 12 d(165.58±10.33)mmH_(2)O were significantly lower than control group,the difference was statistically significant(t=6.401,9.694,10.633,6.277,P<0.05).The neurological function score of observation group(15.23±1.06)points was significantly lower than that of control group,and the Barthel index(75.59±5.33)points was higher than that of control group 3 d after operation,the difference was statistically significant(t=25.972,12.335,P<0.05).The total incidence of postoperative complications in the observation group was 4.00% lower than that in the control group,the difference was statistically significant(χ^(2)=4.878,P<0.05).Conclusion Patients with ruptured intracranial aneurysm undergoing ultra-early microsurgery combined with continuous lumbar cistern drainage have a definite effect,which can effectively reduce the pressure of the patient's cerebrospinal fluid,promote neurological recovery,and reduce postoperative complications.It is wort

关 键 词：持续腰大池引流 超早期显微手术 颅内动脉瘤破裂 治疗 效果 

分 类 号：R651[医药卫生—外科学]