CAJ | 학술논문

目的：探讨动脉瘤性蛛网膜下腔出血（ aSAH）术后行腰椎穿刺术预防慢性脑积水的效果。方法选取2013年3月～2014年5月本科室收治的经全脑血管造影术（ DSA）确诊的aSAH患者57例，其中行开颅动脉瘤夹闭术18例，介入栓塞术39例，并发急性脑积水行侧脑室引流术2例，术后通过早期、间断行腰椎穿刺术引流血性脑脊液来预防慢性脑积水的发生。结果出现亚急性脑积水1例，慢性脑积水3例，其中1例为术前检查存在急性脑积水者，慢性脑积水发生率为5．26％，3例慢性脑积水患者均行脑室-腹腔分流术，术后临床症状有所减轻，其余患者均随访3个月以上，未出现脑积水的情况。结论 aSAH患者术后早期、间断行腰椎穿刺术引流蛛网膜下腔内的积血可降低慢性脑积水的发生率。
목적：탐토동맥류성주망막하강출혈（ aSAH）술후행요추천자술예방만성뇌적수적효과。방법선취2013년3월～2014년5월본과실수치적경전뇌혈관조영술（ DSA）학진적aSAH환자57례，기중행개로동맥류협폐술18례，개입전새술39례，병발급성뇌적수행측뇌실인류술2례，술후통과조기、간단행요추천자술인류혈성뇌척액래예방만성뇌적수적발생。결과출현아급성뇌적수1례，만성뇌적수3례，기중1례위술전검사존재급성뇌적수자，만성뇌적수발생솔위5．26％，3례만성뇌적수환자균행뇌실-복강분류술，술후림상증상유소감경，기여환자균수방3개월이상，미출현뇌적수적정황。결론 aSAH환자술후조기、간단행요추천자술인류주망막하강내적적혈가강저만성뇌적수적발생솔。
[ ABSTRACT] Objective To explore the effect of Lumbar puncture prevention of chronic hydrocephalus for postoperative aneurysmal subarachnoid hemorrhage .Methods Fifty-seven patients of aneurysmal subarachnoid hemor-rhage with a full diagnosis of cerebral angiography (DSA) were selected.Eighteen cases of cranial aneurysm surgery ,39 cases of embolization ,2 cases of lateral drainage with complication of acute hydrocephalus .After surgery , using lumbar puncture to drainage the BCSF early and Intermittently to reduce the incidence of chronic hydrocephalus .Results One case was subacute hydrocephalus ,3 cases were chronic hydrocephalus ,among them one case was acute hydrocephalus of preoperative presence ,the occurrence rate of chronic hydrocephalus was 5.26%.Three cases of chronic hydrocephalus patients had done ventricle-peritoneal shunt ,their clinical symptoms had abated after surgery ,other patients were followed up 3 month or more and no hydrocephalus occurred .Conclusion For the patients of postoperative aneurysmal subarach-noid hemorrhage ,using lumbar puncture to drainage the blood within the subarachnoid space early and intermittently can reduce the incidence of chronic hydrocephalus .