脑脊液置换术联合血管内介入栓塞术治疗动脉瘤性蛛网膜下腔出血患者的效果  

Effects of cerebrospinal fluid replacement combined with endovascular interventional embolization in treatment of patients with aneurysmal subarachnoid hemorrhage

作　　者：甄真 ZHEN Zhen(Neurological Department of Yuzhou Central Hospital,Xuchang 461670 Henan,China)

机构地区：[1]禹州市中心医院经内科,河南许昌461670

出　　处：《中国民康医学》2023年第2期4-7,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察脑脊液置换术联合血管内介入栓塞术治疗动脉瘤性蛛网膜下腔出血(aSAH)患者的效果。方法:选取2018年1月至2021年6月该院收治的60例aSAH患者进行前瞻性研究,按随机数字表法分为对照组和观察组各30例。对照组采用血管内介入栓塞术治疗,观察组在对照组基础上采用脑脊液置换术治疗。比较两组症状改善时间,治疗前后内皮素(ET)、降钙素基因相关肽(CGRP)水平,美国国立卫生研究院卒中量表(NIHSS)评分,以及术后并发症发生率。结果:观察组术后颅内压恢复时间、脑膜刺激征消失时间、意识恢复时间及住院时间均短于对照组,差异有统计学意义(P<0.05);观察组治疗后血清ET水平及NIHSS评分均低于对照组,CGRP水平高于对照组,差异有统计学意义(P<0.05);观察组术后脑积水、脑血管痉挛等并发症发生率均低于对照组,差异有统计学意义(P<0.05);两组术后再出血发生率比较,差异无统计学意义(P>0.05)。结论:脑脊液置换术联合血管内介入栓塞术治疗aSAH患者,可加快临床症状缓解,降低脑血管痉挛、脑积水发生率,改善脑血管舒缩功能,效果优于单用血管内介入栓塞术。Objective: To investigate effects of cerebrospinal fluid replacement combined with endovascular interventional embolization in treatment of patients with aneurysmal subarachnoid hemorrhage(aSAH). Methods: A prospective study was conducted on 60 patients with aSAH admitted to the hospital from January 2018 to June 2021. They were divided into control group and observation group according to the random number table method, 30 cases in each. The control group was treated with intravascular interventional embolization, while the observation group was treated with cerebrospinal fluid replacement on the basis of that of the control group. The symptom improvement time, the levels of endothelin(ET) and calcitonin gene-related peptide(CGRP) before and after the treatment, the national institutes of health stroke scale(NIHSS) score, and the incidence of postoperative complications were compared between the two groups. Results: The recovery time of intracranial pressure, the disappearance time of meningeal irritation sign, the recovery time of consciousness and the hospitalization time in the observation group were shorter than those in the control group, and the differences were statistically significant(P<0.05). The serum ET level and the NIHSS score in the observation group were lower than those in the control group;the CGRP level was higher than that of the control group;and the differences were statistically significant(P<0.05). Further, the incidence of postoperative hydrocephalus and cerebral vasospasm in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). However, there was no significant difference in the postoperative rebleeding rate between the two groups(P>0.05). Conclusions: Cerebrospinal fluid replacement combined with endovascular interventional embolization in the treatment of the aSAH patients can accelerate the relief of clinical symptoms, reduce the incidence of cerebral vasospasm and hydrocephalus, and improve the function of cerebral

关 键 词：血管内介入栓塞术 脑脊液置换术 颅内动脉瘤 蛛网膜下腔出血 

分 类 号：R743[医药卫生—神经病学与精神病学]