不同引流速度腰大池置管脑脊液持续引流术对颅内动脉瘤性蛛网膜下腔出血患者的影响  

Effect of Different Drainage Speeds Continuous Cerebrospinal Fluid Drainage Operation with Lumbar Cistern Catheterization on Patients with Intracranial Aneurysmal Subarachnoid Hemorrhage

作　　者：伊鹏 周绍福 YI Peng;ZHOU Shaofu(Longyan People’s Hospital,Longyan 364000,China;不详)

机构地区：[1]龙岩人民医院,福建龙岩364000

出　　处：《中外医学研究》2022年第35期38-42,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨不同引流速度腰大池置管脑脊液持续引流术对颅内动脉瘤性蛛网膜下腔出血患者的影响。方法:选取2018年12月-2020年12月龙岩人民医院收治的62例颅内动脉瘤性蛛网膜下腔出血患者。随机将其分为A组(31例)和B组(31例)。两组均给予基础对症治疗,两组均行腰大池置管脑脊液持续引流术,A组以10 ml/h的速度引流,B组以15 ml/h的速度引流。比较两组围手术期指标,治疗前和治疗1、3 d后脑脊液指标,治疗前、治疗1 d及治疗后7 d血清指标,治疗前后认知功能及并发症。结果:两组脑脊液澄清、颅内压恢复及颈强直持续时间比较差异均无统计学意义(P>0.05)。治疗1 d后,两组血清血管内皮生长因子(VEGF)、可溶性细胞间黏附分子-1(sICAM-1)、热休克蛋白60(HSP60)、热休克蛋白90(HSP90)、脑脊液C反应蛋白(CRP)、白细胞介素-6(IL-6)水平较治疗前均显著升高(P<0.05),治疗后7 d,两组血清VEGF、sICAM-1、HSP60、HSP90水平明显降低,A组血清VEGF、sICAM-1、HSP60、HSP90水平均显著低于B组(P<0.05)。治疗3 d后两组脑脊液CRP、IL-6水平较治疗前明显降低(P<0.05),两组脑脊液CRP、IL-6水平比较差异均无统计学意义(P>0.05)。治疗后,两组空间与执行力、记忆与注意力、定向力评分均较治疗前升高(P<0.05),A组空间与执行力、记忆与注意力、定向力评分均明显高于B组(P<0.05)。两组颅内感染和脑积水发生率比较差异无统计学意义(P>0.05),A组颅内低压综合征发生率显著低于B组(P<0.05)。结论:腰大池置管脑脊液持续引流术中应用10 ml/h能及时减轻血管损伤,可改善患者认知功能,对患者预后康复有利。Objective:To explore the effect of different drainage speeds continuous cerebrospinal fluid drainage operation with lumbar cistern catheterization on patients with intracranial aneurysmal subarachnoid hemorrhage.Method:A total of 62 patients with intracranial aneurysmal subarachnoid hemorrhage admitted to Longyan People’s Hospital from December 2018 to December 2020 were selected.They were randomly divided into group A(31 cases)and group B(31 cases).Both groups were given basic symptomatic treatment.Both groups received continuous cerebrospinal fluid drainage operation with lumbar cistern catheterization.Group A was drained at a rate of 10 ml/h,while group B was drained at a rate of 15 ml/h.Perioperative indexes,cerebrospinal fluid indexes before treatment,1 and 3 days after treatment,serum indexes before treatment,1 and 7 days after treatment,cognitive function before and after treatment and complications were compared between the two groups.Result:There were no significant differences in Cerebrospinal fluid clarified,intracranial pressure recovery and duration of cervical stiffness between the two groups(P>0.05).After 1 day of treatment,serum vascular endothelial growth factor(VEGF),soluble intercellular adhesion molecule-1(sICAM-1),heat shock protein 60(HSP60),heat shock protein 90(HSP90),cerebrospinal fluid C-reactive protein(CRP)and interleukin-6(IL-6)in the two groups were significantly higher than those before treatment(P<0.05).After 7 days of treatment,serum levels of VEGF,sICAM-1,HSP60 and HSP90 in two groups were significantly decreased,and serum levels of VEGF,sICAM-1,HSP60 and HSP90 in group A were significantly lower than those in group B(P<0.05).After 3 days of treatment,CRP and IL-6 levels in cerebrospinal fluid of the two groups were significantly decreased compared with those before treatment(P<0.05),and there were no significant differences in CRP and IL-6 levels between the two groups(P>0.05).After treatment,the scores of spatial and executive power,memory and attention,and orienting power in

关 键 词：脑大池置管 脑脊液持续引流术 引流速度 颅内动脉瘤性蛛网膜下腔出血 

分 类 号：R743.35[医药卫生—神经病学与精神病学]