[动脉瘤性蛛网膜下腔出血急性期脑脊液引流对脑积水形成的影响]

[Effect of drainage of the cerebrospinal fluid at the acute period of aneurysmal subarachnoid hemorrhage on the formation of hydrocephalus].

作者信息

Song Jin-ning, Liu Shou-xun, Bao Gang, Wang Tuo, Liang Qi, Tan Zhen, Zhang Xiao-dong, Xu Gao-feng, Xie Chang-hou

机构信息

Department of Neurosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shanxi, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2007 Jun;19(6):329-31.

PMID:17577435

Abstract

OBJECTIVE

To discuss the effect of drainage of the cerebrospinal fluid (CSF) at acute period after aneurysmal subarachnoid hemorrhage (SAH) on the formation of hydrocephalus.

METHODS

Eighty-four patients with aneurysmal SAH were randomly divided into two groups according to therapeutic regimen. Forty-two cases in specific treatment group were given intravascular embolism at the acute period of hemorrhage after a ruptured aneurysm, then CSF was drained immediately. Forty-two cases were in conventional expectant treatment group. Clinical data and incidence of hydrocephalus of specific treatment group and conventional expectant treatment group were analyzed.

RESULTS

Clinical data did not show any differences between two groups, so they could be compared (all P>0.05). The incidence rate of acute hydrocephalus in specific treatment group was 7.14% (3/42 cases), that of subacute hydrocephalus was 4.76% (2/42 cases), and that of chronic hydrocephalus was 16.67% (7/42 cases). The total incidence rate was 28.57%. In conventional expectant treatment group, the incidence rate of acute hydrocephalus was 23.81% (10/42 cases), incidence of subacute hydrocephalus was 9.52% (4/42 cases), and that of chronic hydrocephalus was 35.71% (15/42 cases), and total incidence rate was 69.05%. There was significant difference between specific treatment group and conventional expectant treatment group in incidence of acute and chronic hydrocephalus (acute chi (2)=4.46, chronic chi (2)=3.94, both P<0.05), and there was no difference in subacute hydrocephalus between two groups (chi (2)=0.72, P>0.05), but significant difference was found in total incidence rate between two groups (chi (2)=13.77, P<0.01).

CONCLUSION

Embolization of the intracranial aneurysm with interventional treatment at the acute hemorrhage stage (within 7 days) for the aneurysmal SAH, followed by immediate drainage of CSF can prevent hydrocephalus or alleviate hydrocephalus, and the treatment plays a significant role in the formation and development of hydrocephalus.

摘要

目的

探讨动脉瘤性蛛网膜下腔出血（SAH）急性期脑脊液引流对脑积水形成的影响。

方法

84例动脉瘤性SAH患者根据治疗方案随机分为两组。特定治疗组42例在动脉瘤破裂出血急性期行血管内栓塞，然后立即行脑脊液引流。42例为传统期待治疗组。分析特定治疗组和传统期待治疗组的临床资料及脑积水发生率。

结果

两组临床资料差异无统计学意义，具有可比性（均P>0.05）。特定治疗组急性脑积水发生率为7.14%（3/42例），亚急性脑积水发生率为4.76%（2/42例），慢性脑积水发生率为16.67%（7/42例），总发生率为28.57%。传统期待治疗组急性脑积水发生率为23.81%（10/42例），亚急性脑积水发生率为9.52%（4/42例），慢性脑积水发生率为35.71%（15/42例），总发生率为69.05%。特定治疗组与传统期待治疗组急性和慢性脑积水发生率比较差异有统计学意义（急性χ²=4.46，慢性χ²=3.94，均P<0.05），两组亚急性脑积水发生率比较差异无统计学意义（χ²=0.72，P>0.05），但两组总发生率比较差异有统计学意义（χ²=13.77，P<0.01）。