脑脊液引流速度和引流量对动脉瘤性蛛网膜下腔出血患者术后脑脊液生化指标和并发症的影响  

Effects of drainage velocity and volume of cerebrospinal fluid on postoperative biochemical indexes in cerebrospinal fluid and complications in patients with Aneurysmal subarachnoid hemorrhage

作　　者：龚绍慧 龚绍赟 黄丹坪 徐建平 张永安 GONG Shaohui;GONG Shaoyun;HUANG Danping;XU Jianping;ZHANG Yongan(Department of Neurosurgery,Shangrao People's Hospital,Jiangxi Province,Shangrao334000,China;Department of Neurology,Shangrao Municipal Hospital,Jiangxi Province,Shangrao334000,China)

机构地区：[1]江西省上饶市人民医院神经外科,江西上饶334000 [2]江西省上饶市立医院神经内科,江西上饶334000

出　　处：《中国当代医药》2024年第31期33-36,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202410963)。

摘　　要：目的分析脑脊液引流速度和引流量对动脉瘤性蛛网膜下腔出血(aSAH)患者术后脑脊液生化指标和并发症的影响。方法选择2021年1月至2023年3月的上饶市人民医院收治的60例aSAH患者作为研究对象,采用随机数表法将其分为对照组(引流速度5 ml/h,引流量<250 ml)和研究组(引流速度10 ml/h,引流量≥250 ml),各30例。比较两组围手术期指标、C反应蛋白(CRP)、白细胞介素-6(IL-6)、乳酸(LAC)、氯化物(CL)、蒙特利尔认知评估量表(MoCA-BJ)、并发症发生率。结果两组的围手术期指标比较,差异无统计学意义(P>0.05)。两组患者治疗前和治疗1、3 d后的CRP、IL-6、CL时间比较差异有统计学意义(P<0.05),LAC时间、交互比较差异有统计学意义(P<0.05);研究组治疗3 d后的CRP、IL-6、LAC、CL低于对照组,差异有统计学意义(P<0.05)。研究组治疗后的MoCA-BJ评分高于对照组,差异有统计学意义(P<0.05)。研究组的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论高引流速度、高引流量的脑室外引流术可更好地促进脑脊液各项指标恢复,改善患者认知功能,减少并发症发生。Objective To analyze the effects of drainage velocity and volume of cerebrospinal fluid on postoperative biochemical indexes in cerebrospinal fluid and complications in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 60 patients with aSAH admitted to Shangrao People's Hospital from January 2021 to March 2023 were selected as the study objects.According to random number table method,they were divided into control group(drainage velocity:5 ml/h,drainage volume:<250 ml)and study group(drainage velocity:10 ml/h,drainage volume≥250 ml),30 cases in each group.The perioperative indexes,C-reactive protein(CRP),interleukin-6(IL-6),lactic acid(LAC),chloride(CL)in cerebrospinal fluid,cognitive function Montreal cognitive assessment(MoCA-BJ)and incidence of complications were compared between the two groups.Results There were no significant differences in perioperative indexes between the two groups(P>0.05).There were statistically significant differences in CRP,IL-6 and CL time between the two groups before treatment,1 day and 3 days after treatment(P<0.05),and statistically significant differences in LAC time and interaction comparison between the two groups(P<0.05).CRP,IL-6,LAC and CL of the study group after 3 d treatment were lower than those of the control group,and the differences were statistically significant(P<0.05).The MoCA-BJ score of the study group after treatment was higher than that of the control group,and the difference was statistically significant(P<0.05).The total complication rate of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion External ventricular drainage with high drainage velocity and volume can better promote the recovery of cerebrospinal fluid indexes,improve cognitive function and reduce complications.

关 键 词：脑脊液 引流速度 引流量 动脉瘤性蛛网膜下腔出血 脑脊液生化指标 并发症 

分 类 号：R743[医药卫生—神经病学与精神病学]