| 宁亮,谢兰军,梁卫东,朱司阳,刘俊.腰大池引流预防脑动脉瘤破裂出血术后脑积水及其预后影响因素分析.[J].中南医学科学杂志.,2021,(3):344-347. |
| 腰大池引流预防脑动脉瘤破裂出血术后脑积水及其预后影响因素分析 |
| Prevention of postoperative hydrocephalus after cerebral aneurysm rupture by lumbar cistern drainage and analysis of prognostic factors |
| 投稿时间：2020-12-31 修订日期：2021-02-25 |
| DOI：10.15972/j.cnki.43-1509/r.2021.03.021 |
| 中文关键词: 腰大池引流 脑动脉瘤破裂出血 脑积水 预后 |
| 英文关键词:lumbar cistern drainage cerebral aneurysm rupture and hemorrhage hydrocephalus prognosis |
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| 中文摘要: |
| 目的探讨腰大池引流对动脉瘤破裂出血术后脑积水的预防效果及预后相关因素分析。方法选取100例脑动脉瘤破裂出血患者,随机分为对照组和腰大池引流组各50例。对照组术后行腰椎穿刺引流,腰大池引流组术后行腰大池引流。比较两组患者治疗前后脑血流速度、格拉斯哥(GOS)预后评分及术后脑积水、脑血管痉挛等并发症情况。分析影响腰大池引流患者预后的相关因素。结果腰大池引流组治疗后脑血流速度明显低于对照组(P＜0.05)；腰大池引流组预后良好率明显优于对照组(P＜0.05)；腰大池引流组术后6月脑积水发生率明显低于对照组(P＜0.05)。患者年龄≥60岁、动脉瘤偏大、Hunt-Hess分级Ⅲ~Ⅴ级、术后脑积水、术后脑血管痉挛患者的预后不良率更高(P＜0.05)。结论腰大池引流可有效预防动脉瘤破裂出血术后脑积水的发生。患者年龄、动脉瘤大小、Hunt-Hess分级、术后脑积水、术后脑血管痉挛发生是影响其预后的重要因素。 |
| 英文摘要: |
| To explore the preventive effect of lumbar cistern drainage on hydrocephalus after operation of aneurysm rupture and hemorrhage and analyze the prognostic factors. Methods100 patients with cerebral aneurysm rupture and hemorrhage were randomly divided into control group and lumbar cistern drainage group, with 50 cases in each group. The control group was treated with lumbar puncture drainage, and the lumbar cistern drainage group was treated with lumbar cistern drainage. The cerebral blood flow velocity (Vm), Glasgow score (GOS) and postoperative complications such as hydrocephalus and cerebral vasospasm were compared between the two groups before and after treatment. The factors influencing the prognosis of patients with ruptured aneurysms were analyzed. ResultsAfter treatment, Vm in lumbar cistern drainage group was significantly lower than that in control group (P＜0.05); the satisfactory rate of prognosis in lumbar cistern drainage group was significantly better than that in control group (P＜0.05); the incidence of hydrocephalus in lumbar cistern drainage group within 6 months after operation was significantly lower than that in control group (P＜0.05). The incidence of poor prognosis was higher in patients with age ≥60 years, larger aneurysm, Hunt-Hess grade Ⅲ－Ⅴ, postoperative hydrocephalus and postoperative cerebral vasospasm (P＜0.05). ConclusionLumbar cistern drainage can effectively prevent hydrocephalus after aneurysm rupture and hemorrhage. Age, aneurysm size, Hunt-Hess grade, postoperative hydrocephalus and cerebral vasospasm are important prognostic factors. |
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