Ommaya囊治疗脑出血并发急性期脑积水疗效及对血脑屏障功能的影响  

Effect of Ommaya Capsule on Cerebral Hemorrhage Complicated with Acute Hydrocephalus and its Effect on Blood-brain Barrier Function

作　　者：汪鑫邦 胡安 赵喜鹏 汪炎 丁伟 操礼鹏 古禹 许轲 张云峰 WANG Xinbang;HU An;ZHAO Xipeng;WANG Yan;DING Wei;CAO Lipeng;GU Yu;XU Ke;ZHANG Yunfeng(Dept.of Neurosurgery,Anqing 116 Hospital,Anqing Anhui 246003,China)

机构地区：[1]安庆一一六医院神经外科,安徽安庆246003

出　　处：《昆明医科大学学报》2024年第10期96-104,共9页Journal of Kunming Medical University

基　　金：海军安庆医院科研课题(HY2021005);安徽省卫生厅医药科研计划项目(10328KJ20209601)。

摘　　要：目的探讨Ommaya囊在脑出血并发急性期脑积水治疗中的应用及对血脑屏障功能和预后的影响。方法选取2021年1月至2023年1月安庆一一六医院脑出血并发急性期脑积水患者80例,按照随机数字表法分组,各40例。对照组给予腰大池介入治疗,观察组给予Ommaya囊介入治疗。比较2组治疗效果、治疗前后血脑屏障(BBB)指数、血清S100β蛋白(S100β)、脑脊液细胞数、葡萄糖、髓鞘碱性蛋白(MBP)、美国国立卫生研究院卒中量表(NIHSS)、特异性烯醇化酶(NSE)、氯化物、中国脑卒中临床神经功能缺损量表(CSS)评分及并发症发生情况,并随访6个月,对比2组预后情况。结果观察组总有效率90.00%(36/40)高于对照组72.50%(29/40),P<0.05;治疗后1周、2周观察组血清S100β、MBP、BBB指数、NSE、脑脊液细胞数水平低于对照组,脑脊液葡萄糖、氯化物水平高于对照组(P<0.05);治疗后1周、2周观察组CSS、NIHSS评分较对照组低(P<0.05);观察组并发症发生率7.50%(3/40)低于对照组25.00%(10/40),P<0.05;随访6个月观察组预后分级情况优于对照组(P<0.05)。结论脑出血并发急性期脑积水患者中应用Ommaya囊治疗,可调控神经损伤因子水平,恢复血脑屏障,改善神经功能,还能降低并发症风险,提升临床疗效,促进预后恢复。Objective To investigate the application of Ommaya capsule in the treatment of cerebral hemorrhage complicated with acute hydrocephalus and its effect on blood-brain barrier function and prognosis.Methods A total of 80 patients with cerebral hemorrhage complicated with acute hydrocephalus from January 2021 to January 2023 were selected and divided into 40 cases each according to random number table method.The control group was given lumbocisterna interventional therapy,and the observation group was given Ommaya capsule interventional therapy.Compare the therapeutic effect of the two groups,as well as blood-brain barrier(BBB)index,serum S100βprotein(S100β),cerebrospinal fluid cell count,glucose,myelin basic protein(MBP),National Institutes of Health Stroke Scale(NIHSS),specific enolase(NSE),chloride,Chinese Stroke Clinical Neurological Deficit Scale(CSS)score and occurrence of complications before and after treatment,were followed up for 6 months,and the prognosis of the two groups was statistically compared,after 6 months of follow-up,the prognosis of the two groups was statistically compared.Results The total effective rate of observation group was 90.00%(36/40),which is higher than that of control group(72.50%(29/40)(P<0.05).The levels of serum S100β,MBP,BBB index,NSE and CSF cell number in observation group were lower than those in control group 1 week and 2 weeks after treatment,and the levels of CSF glucose and chloride were higher than those in control group(P<0.05).The CSS and NIHSS scores of observation group were lower than those of control group 1 and 2 weeks after treatment(P<0.05);The complication rate of the observation group was 7.50%(3/40)lower than that of the control group(25.00%(10/40)(P<0.05).The prognosis of observation group was better than control group(P<0.05)after 6 months of follow-up.Conclusion The application of Ommaya capsule therapy in patients with cerebral hemorrhage complicated with acute hydrocephalus can regulate the level of nerve injury factors,restore the blood-brain barrie

关 键 词：脑出血 脑脊液 脑积水 神经功能 屏障功能 OMMAYA囊 腰大池介入 

分 类 号：R742.7[医药卫生—神经病学与精神病学]