[1]周星辰,束汉生,王大巍,等.腰大池引流在预防颅内动脉瘤破裂术后脑血管痉挛发生中的应用价值[J].医学信息,2020,33(05):109-110118.[doi:10.3969/j.issn.1006-1959.2020.05.034]
　ZHOU Xing-chen,SHU Han-sheng,WANG Da-wei,et al.Application Value of Lumbar Large Pond Drainage in Preventing Cerebral Vasospasm after Intracranial Aneurysm[J].Medical Information,2020,33(05):109-110118.[doi:10.3969/j.issn.1006-1959.2020.05.034]
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腰大池引流在预防颅内动脉瘤破裂术后脑血管痉挛发生中的应用价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年05期
页码:
109-110118
栏目:
临床研究
出版日期:
2020-03-01

文章信息/Info

Title:
Application Value of Lumbar Large Pond Drainage in Preventing Cerebral Vasospasm after Intracranial Aneurysm
文章编号:
1006-1959（2020）05-109-03
作者:
周星辰; 束汉生; 王大巍; 等
（蚌埠医学院第二附属医院神经外科，安徽 蚌埠 233000）
Author(s):
ZHOU Xing-chen; SHU Han-sheng; WANG Da-wei; et al
(Department of Neurosurgery,the Second Affiliated Hospital of Bengbu Medical College,Bengbu 233000,Anhui,China)
关键词:
颅内动脉瘤; 脑血管痉挛; 腰大池引流; 腰椎穿刺
Keywords:
Intracranial aneurysm; Cerebral vasospasm; Large lumbar drainage; Lumbar puncture
分类号:
R743
DOI:
10.3969/j.issn.1006-1959.2020.05.034
文献标志码:
A
摘要:
目的 分析腰大池引流在预防颅内动脉瘤破裂术后脑血管痉挛发生中的应用价值。方法 回顾性分析2017年4月~2019年4月我院收治的90例颅内动脉瘤破裂患者临床资料，根据治疗方式不同分为观察组（50例）和对照组（40例）。观察组早期给予腰大池持续引流脑脊液治疗，对照组早期给予间断腰椎穿刺释放脑脊液治疗，比较两组术后24 h、6 d、10 d颅内压、脑脊液红细胞计数；随访3个月，比较两组脑血管痉挛发生率、脑积水发生率。结果 术后24 h，两组颅内压及脑脊液红细胞计数比较，差异无统计学意义（P＞0.05）；术后6、10 d，两组颅内压及脑脊液红细胞计数均较术后24 h下降，且观察组低于对照组，差异有统计学意义（P＜0.05）；观察组脑血管痉挛和脑积水发生率分别为4.00%、2.00%，低于对照组的20.00%、15.00%，差异有统计学意义（P＜0.05）。结论 在颅内动脉瘤破裂患者中早期应用腰大池持续引流脑脊液，可以有效降低颅内压力，减少脑脊液红细胞计数，降低脑血管痉挛和脑积水发生率。
Abstract:
Objective To analyze the application value of large lumbar drainage in the prevention of cerebral vasospasm after intracranial aneurysm rupture.Methods The clinical data of 90 patients with intracranial aneurysm rupture admitted in our hospital from April 2017 to April 2019 were retrospectively analyzed. They were divided into observation group (50 cases) and control group (40 cases) according to different treatment methods. The observation group was treated with continuous drainage of cerebrospinal fluid at the early stage of the lumbar great pond, and the control group was treated with intermittent lumbar puncture to release cerebrospinal fluid at the early stage. The intracranial pressure and cerebrospinal fluid red blood cell count were compared at 24 h, 6 d, and 10 d after surgery in the two groups.Follow-up for 3 months, the incidence of cerebral vasospasm and hydrocephalus were compared between the two groups.Results At 24 h after operation, there was no significant difference in intracranial pressure and cerebrospinal fluid red blood cell counts between the two groups (P>0.05). At 6 and 10 d after operation, intracranial pressure and cerebrospinal fluid red blood cell counts decreased in both groups compared with 24 h after surgery. And the observation group was lower than the control group, the difference was statistically significant (P<0.05); the incidence of cerebral vasospasm and hydrocephalus in the observation group were 4.00% and 2.00%, which were lower than the control group’s 20.00% and 15.00%,the difference was statistically significant (P<0.05).Conclusion Early application of lumbar great cistern to continuously drain cerebrospinal fluid in patients with ruptured intracranial aneurysms can effectively reduce intracranial pressure, reduce cerebrospinal fluid red blood cell count, and reduce the incidence of cerebral vasospasm and hydrocephalus.

参考文献/References:

[1]Geng L,Ma F,Liu Y,et al.Massive Cerebrospinal Fluid Replacement Reduces Delayed Cerebral Vasospasm After Embolization of Aneurysmal Subarachnoid Hemorrhage[J].Med Sci Monit,2016(22):2404-2408.[2]胡震,林生,黄文立,等.丁苯酞联合前列地尔治疗动脉瘤性蛛网膜下腔出血伴脑血管痉挛患者的疗效观察[J].广西医科大学学报,2019,36(7):1143-1147.[3]苗贺.3H疗法治疗自发性蛛网膜下腔出血继发脑血管痉挛效果观察[J].实用中西医结合临床,2018,18(11):109-110.[4]Tagami T,Kuwamoto K,Watanabe A,et al.Effect of triple-h prophylaxis on global end-diastolic volume and clinical outcomes in patients with aneurysmal subarachnoid hemorrhage[J].Eurocrit Care,2014,21(3):462-469.[5]李晖,戴孝森,卓开全.尼莫地平与前列地尔联合治疗动脉瘤性蛛网膜下腔出血伴脑血管痉挛患者炎症因子和ET-1、CGRP、VEGF水平的影响[J].脑与神经疾病杂志,2019,27(7):438-442.[6]郑云锋,韦纬,黄元志,等.动脉瘤性蛛网膜下腔出血脑血管痉挛患者心电图检测的临床意义[J].内科急危重症杂志,2018,24(3):242-243,247.[7]喻蕾.内皮素、氧合血红蛋白与蛛网膜下腔出血后脑血管痉挛的关系[J].中国实用医药,2015(20):48-49.[8]贾建文,钟红亮,彭汤明,等.早期持续腰大池引流对颅内动脉瘤栓塞术患者的疗效[J].中国老年学杂志,2018,38(21):5145-5146.[9]赵珂,岳慧丽,苗旺.腰椎穿刺脑脊液置换对不同H-H分级蛛网膜下腔出血预后的影响[J].卒中与神经疾病,2018,25(3):284-287.

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更新日期/Last Update: 2020-03-01