Hirashima Y, Endo S, Horie Y, Kurimoto M
Department of Neurosurgery, Toyama Medical and Pharmaceutical University, Japan.
Br J Neurosurg. 1996 Oct;10(5):477-81. doi: 10.1080/02688699647113.
The use of cisternal drainage can lead to complications such as shunt-dependent hydrocephalus and meningitis. We assessed the indications for cisternal irrigation with urokinase in postoperative patients with aneurysmal subarachnoid haemorrhage (SAH). The SAH scores by CT on admission and on the day after surgery were used to evaluate two parameters: the total amount of subarachnoid blood on admission and the clearance rate of subarachnoid blood by surgery. In patients whose parameters values belonged to the range where the total SAH score on admission exceeded 10 points and the surgical clearance rate was less than 50%, the possibility of cerebral infarction was significantly higher in patients without than in those with irrigation (p < 0.05). However, there was no difference between patients with and without irrigation for parameter values outside of the range. Therefore, this range may be useful in providing stricter indications for irrigation therapy with urokinase and thus avoiding the complications of cisternal drainage.
使用脑池引流可导致诸如分流依赖型脑积水和脑膜炎等并发症。我们评估了在动脉瘤性蛛网膜下腔出血（SAH）术后患者中使用尿激酶进行脑池冲洗的指征。利用入院时及术后第一天CT的SAH评分来评估两个参数：入院时蛛网膜下腔积血总量以及手术清除蛛网膜下腔积血的清除率。对于入院时SAH总分超过10分且手术清除率低于50%这一参数值范围的患者，未进行冲洗的患者发生脑梗死的可能性显著高于进行冲洗的患者（p<0.05）。然而，对于参数值不在该范围的患者，进行冲洗和未进行冲洗的患者之间并无差异。因此，该范围可能有助于为尿激酶冲洗治疗提供更严格的指征，从而避免脑池引流的并发症。
