中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
20期
9067-9070
,共4页
张坤%罗祺%陈儇%孟祥坤%徐宁
張坤%囉祺%陳儇%孟祥坤%徐寧
장곤%라기%진현%맹상곤%서저
自发性蛛网膜下腔出血%血管痉挛,颅内%Hunt-Hess%持续腰池引流%延迟性缺血性神经功能障碍
自髮性蛛網膜下腔齣血%血管痙攣,顱內%Hunt-Hess%持續腰池引流%延遲性缺血性神經功能障礙
자발성주망막하강출혈%혈관경련,로내%Hunt-Hess%지속요지인류%연지성결혈성신경공능장애
Spontaneous subarachnoid hemorrhage%Vasospasm,intracranial%Hunt-Hess%Continuous lumbar cisterna drainage%Delayed ischemic neurological deficit
目的:探讨动脉瘤性蛛网膜下腔出血(aSAH)行动脉瘤夹闭术前早期持续腰池引流对患者并发症的发生及预后的影响。方法回顾性研究收集2010年1月至2013年1月320例aSAH患者行持续腰池引流后接受动脉瘤夹闭手术治疗患者的病例资料,并与未行引流治疗的200例同期患者的病例资料进行对照研究。探讨两组患者的预后、并发症差别。结果持续腰池引流组患者预后较对照组明显提高(P=0.011),显著降低动脉瘤夹闭术后脑积水(χ2=11.10,P=0.01)、迟发性缺血性神经功能障碍(χ2=4.86, P=0.03)以及颅内感染的发生率(χ2=0.39,P=0.53)。结论对于aSAH患者夹闭术前早期行持续腰池引流治疗是较合理的选择,对改善患者预后及减少并发症的发生具有重大意义。
目的:探討動脈瘤性蛛網膜下腔齣血(aSAH)行動脈瘤夾閉術前早期持續腰池引流對患者併髮癥的髮生及預後的影響。方法迴顧性研究收集2010年1月至2013年1月320例aSAH患者行持續腰池引流後接受動脈瘤夾閉手術治療患者的病例資料,併與未行引流治療的200例同期患者的病例資料進行對照研究。探討兩組患者的預後、併髮癥差彆。結果持續腰池引流組患者預後較對照組明顯提高(P=0.011),顯著降低動脈瘤夾閉術後腦積水(χ2=11.10,P=0.01)、遲髮性缺血性神經功能障礙(χ2=4.86, P=0.03)以及顱內感染的髮生率(χ2=0.39,P=0.53)。結論對于aSAH患者夾閉術前早期行持續腰池引流治療是較閤理的選擇,對改善患者預後及減少併髮癥的髮生具有重大意義。
목적:탐토동맥류성주망막하강출혈(aSAH)행동맥류협폐술전조기지속요지인류대환자병발증적발생급예후적영향。방법회고성연구수집2010년1월지2013년1월320례aSAH환자행지속요지인류후접수동맥류협폐수술치료환자적병례자료,병여미행인류치료적200례동기환자적병례자료진행대조연구。탐토량조환자적예후、병발증차별。결과지속요지인류조환자예후교대조조명현제고(P=0.011),현저강저동맥류협폐술후뇌적수(χ2=11.10,P=0.01)、지발성결혈성신경공능장애(χ2=4.86, P=0.03)이급로내감염적발생솔(χ2=0.39,P=0.53)。결론대우aSAH환자협폐술전조기행지속요지인류치료시교합리적선택,대개선환자예후급감소병발증적발생구유중대의의。
Objective To evaluate the influence of early continuous lumbar cisterna drainage before clipping on patients' complications and recovery with aneurysmal subarachnoid hemorrage. Methods A retrospective study of 320 cases of ruptured aneurysm undergo continuous lumbar cisterna drainage before operation from January 2010 to January 2013 in the hospital, and to compare them with 200 cases with no continuous lumbar cisterna drainage at the same period.To discuss the differences on recovery and complications of the two groups. Results Compared with the no-drainage group, the continuous lumbar cisterna drainage group showed significant progress in recovery (P<0.05), and significantly reduced the occurance rates of cerebral vasospasm, delayed ischemic neurological deficit( DIND) and intracranial infection. It did't increase the risk of intracranial infection(P>0.05). Conclusion It's a reasonable choice to undergo continuous lumbar cisterna drainage before aneurysm clipping. It can effectively improve the outcome and reduce the occurance of complications.