颅内动脉瘤破裂急性期的腰椎硬脊膜下腔压力与颅内压的关系分析  

Relationship between lumbar subdural pressure and intracranial pressure in acute stage of ruptured intracranial aneurysms

作　　者：熊颜辉 干小强 杨绮帆 莫希 Xiong Yan-hui;Qian Xiao-qiang;Yang Yi-fan(Department of Neurosurgery,334 Hospital Affiliated to Nanchang University,Nanchang 330024,China)

机构地区：[1]南昌大学附属三三四医院神经外科,江西南昌330024 [2]不详

出　　处：《四川生理科学杂志》2023年第12期2259-2261,共3页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨颅内动脉瘤破裂急性期的腰椎硬脊膜下腔压力与颅内压的关系。方法:选取2019年8月~2022年8月南昌三三四医院收治的60例急性颅内动脉瘤破裂、蛛网膜下腔出血患者为研究对象。所有患者均接受急诊开颅或血管介入栓塞术治疗,术后6 h复查头颅CT确认无异常后安置脑实质型颅内压探头于腰大池硬脊膜下腔,记录患者的腰椎硬脊膜下腔压力与颅内压,分析两者的关系。结果:术后1 d、术后2 d、术后3 d、术后5 d、术后7 d患者的腰椎硬脊膜下腔压力均高于患者的颅内压,差异有统计学意义(P<0.05)。相关性分析显示,腰椎硬脊膜下腔压力与颅内压呈正相关(r=0.526,P<0.05)。随访结果显示,2例患者术后12 m内复发,其余58例患者无复发。结论:颅内动脉瘤破裂急性期的腰椎硬脊膜下腔压力略高于颅内压,两者存在显著的数值差异,且呈正相关。Objective:To investigate the relationship between lumbar subdural pressure and intracranial pressure in acute stage of ruptured intracranial aneurysm.Methods:A total of 60 patients with acute intracranial aneurysm rupture and subarachnoid hemorrhage treated in Nanchang 334th Hospital from August 2019 to August 2022 were selected as the study objects.All patients were treated with emergency craniotomy or vascular interventional embolization.After head CT examination 6h after operation confirmed no abnormality,a cerebral parenchymal intracranial pressure probe was placed in the subdural space of the lumbar cisterna,and the relationship between the lumbar subdural space pressure and intracranial pressure of the patients was recorded and analyzed.Results:The lumbar subdural pressure was higher than the intracranial pressure at 1d,2d,3d,5d and 7d after surgery,and the difference was statistically significant(P<0.05).Correlation analysis showed that lumbar subdural pressure was positively correlated with intracranial pressure(r=0.526,P<0.05).Follow-up results showed that 2 patients recurred within 12 months after surgery,and the remaining 58 patients had no recurrence.Conclusion:The lumbar subdural pressure is slightly higher than the intracranial pressure in the acute stage of ruptured intracranial aneurysm,and there is a significant difference and positive correlation between the two.

关 键 词：颅内动脉瘤破裂 急性期 腰椎硬脊膜下腔压力 颅内压 

分 类 号：R651.1[医药卫生—外科学]