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颅内动脉瘤夹闭术后持续腰椎引流与腰椎穿刺引流治疗动脉瘤性蛛网膜下腔出血的对照研究

A Controlled Study of Continuous Lumbar Drainage of Fluid and Lumbar Puncture Drainage for Aneurysmal SAH after Intracranial Aneurysm Clipping.

机构信息

Department of Neurosurgery, The First People's Hospital of Xianyang, Xianyang, Shaanxi Province, China.

出版信息

J Healthc Eng. 2021 Aug 20;2021:2827493. doi: 10.1155/2021/2827493. eCollection 2021.

Abstract

OBJECTIVE

To analyze the different effects of Continuous Lumbar Drainage of fluid and lumbar puncture drainage for aneurysmal subarachnoid hemorrhage (SAH) after intracranial aneurysm clipping.

METHOD

Seventy-five patients with aneurysmal SAH who underwent aneurysm clipping were retrospectively analyzed and were divided into two groups according to the different postoperative drainage methods. The lumbar spine group received lumbar puncture drainage, and the lumbar cistern group received lumbar pool continuous drainage to compare the efficacy.

RESULT

The time to normalize intracranial pressure and headache relief after drainage treatment in the lumbar cistern group was shorter than that in the lumbar spine group. The GOS score was higher than that in the lumbar spine group, and the cerebral artery flow velocity and NIHSS score were significantly lower than those in the lumbar spine group ( < 0.05). The total effective rate of drainage treatment was 76.32% in the lumbar cistern group, which was higher than that in the lumbar spine group (54.05%) ( < 0.05). The total complication rate was 18.42% in the lumbar cistern group, which was lower than that in the lumbar spine group (40.54%) ( < 0.05).

CONCLUSION

Continuous Lumbar Drainage of fluid after intracranial aneurysm clipping for aneurysmal SAH can control symptoms more rapidly, reduce neurological deficits, and improve prognosis than lumbar puncture. Also, the drainage is safer and more widely used.

摘要

目的

分析颅内动脉瘤夹闭术后持续腰椎引流与腰椎穿刺引流对动脉瘤性蛛网膜下腔出血(SAH)的不同影响。

方法

回顾性分析 75 例行颅内动脉瘤夹闭术的动脉瘤性蛛网膜下腔出血患者,根据术后不同引流方法分为两组,腰椎组行腰椎穿刺引流,腰椎池组行腰椎池持续引流,比较疗效。

结果

腰椎池组引流治疗后颅内压恢复正常和头痛缓解时间短于腰椎组,GOS 评分高于腰椎组,大脑动脉血流速度和 NIHSS 评分均明显低于腰椎组( < 0.05)。腰椎池组引流治疗总有效率为 76.32%,高于腰椎组(54.05%)( < 0.05)。腰椎池组总并发症发生率为 18.42%,低于腰椎组(40.54%)( < 0.05)。

结论

颅内动脉瘤夹闭术后持续腰椎引流治疗动脉瘤性蛛网膜下腔出血能更快控制症状,减轻神经功能缺损,改善预后,且引流更安全,应用更广泛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dde8/8397562/cdaa555bd9bf/JHE2021-2827493.001.jpg

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