脑脊液释放试验对脑积水患者认知功能与运动障碍的影响

Effect of cerebrospinal fluid release test on cognitive function and dyskinesia in patients with hydrocephalus

目的 评估脑脊液释放试验对正常压力脑积水（NPH）患者认知功能与运动障碍的影响。方法 对78例NPH患者行脑脊液释放试验，缓慢释放30 ml脑脊液，在释放试验前、试验后第4、8、24、72小时评估患者的认知功能与运动障碍，采用Spearman相关性分析评估影像学指标与脑脊液释放试验后临床指标的相关性。结果 与放液前比较，放液后患者第8、24小时的行走时间显著缩短，差异有统计学意义（P〈0.05）；放液后患者第8小时行走步数显著降低，差异有统计学意义（P〈0.05）；放液后患者第24、72小时的认知评分显著改善，差异有统计学意义（P〈0.05）。Spearman相关性分析显示，扩大的外侧裂与蛛网膜下腔凸面变窄不匹配与脑脊液释放试验后行走时间、行走步数与认知评分不相关。结论 正常压力脑积水患者脑脊液释放试验后运动障碍与认知功能显著改善，建议在脑脊液释放试验8 h后至少进行1次患者认知功能与行走功能的评估。

Objective To evaluate the effect of cerebrospinal fluid release test on cognitive function and dyskinesia in patients with normal pressure hydrocephalus （NPH）.Methods Seventy cases of NPH were treated by cerebrospinal fluid release test, slowly released 30 ml cerebrospinal fluid （CSF）. Before and 4th, 8th, 24th, 72nd hour after release test, Spearman correlation analysis was used to assess the relationship between the imaging parameters and clinical parameters after the CSF release test.Results Compared with before discharge, 8th, 24th hour of walking time after the infusion was significantly shortened, the difference was significant （P〈0.05）; The number of walking steps in the 8th hour after release was significantly reduced, and the difference was significant （P〈0.05）; The cognitive score of 24th and 72nd hour after release was significantly improved, and the difference was significant. Spearman correlation analysis showed that the extended lateral fissure was not correlated with the convex narrowing of the subarachnoid cavity and the walking time, walking steps and the cognitive score after the CSF release test.Conclusions After cerebrospinal fluid release test, the motor dysfunction and cognitive function of patients with normal pressure hydrocephalus were significantly improved, it is recommended to evaluate the cognitive function and walking function at least once at 8 h after CSF release test.