动脉瘤性蛛网膜下腔出血后持续腰大池引流的时机对分流依赖性脑积水的影响

Enfluence of the timing of permanent lumbar drainage therapy on shunt-dependent hydrocephalus in patients with aneurysmal subarachnoid hemorrhage

目的分析发生动脉瘤性蛛网膜下腔出血后行持续腰大池置管引流术距出血发生间隔的长短对患者发生分流依赖性脑积水的影响。方法回顾性分析2015年9月至2017年9收治的178例动脉瘤性蛛网膜下腔出血患者,依据患者行腰大池置管引流术距出血的时间分为24小时以内(A组56例)、24~72小时(B组79例)、超出72小时(C组43例)三组,分析行腰大池置管引流距出血时间的长短对分流依赖性脑积水发生的影响。结果三组中发生分流依赖性脑积水为:A组5例(8.9%)、B组8例(10.1%)、C组12例(27.9%)。三组间分流依赖性脑积水的发生率有明显差异(P<0.05)。结论动脉瘤性蛛网膜下腔出血后许越早行持续腰大池引流于预防分流依赖性脑积水的效果越好。

Objective To analysis of the effect of timing of permanent lumbar drainage after aneurysmal subarachnoid hemorrhage on shunt-dependent hydrocephalus in patients.Methods A retrospective analysis was performed in 178 patients with aneurysmal subarachnoid hemorrhage from September 2015 to September 2017.According to the length of the lumbar drainage after subarachnoid hemorrhage,the patients were divided into three groups,group A(within 24 hours,n=56),group B(between 24 hours to 72 hours,n=79),group C(more than 72 hours,n=43).Shunt-dependent hydrocephalus was recorded.Results The shunt-dependent hydrocephalus occurred in the three groups:5 patients in group A(8.9%),8 patients in group B(10.1%),and 12 patients in group C(27.9%).There was a significant difference in the incidence of shunt-dependent hydrocephalus between the three groups(P<0.05).Conclusion Continuous lumbar drainage should be performed as early as possible after aneurysmal subarachnoid hemorrhage to preventing from shunt-dependent hydrocephalus.