破裂颅内动脉瘤介入治疗后早期持续腰池引流的应用

Application of Early Sustained Lumbar Cistern Drainage After Interventional Treatment for Ruptured Intracranial Aneurysms

目的探讨早期持续腰池引流在破裂颅内动脉瘤介入治疗后的临床应用价值分析。方法选取焦作市第二人民医院收治颅内动脉瘤破裂的患者78例,按随机表达法将患者分成对照组(39例)和研究组(39例)。患者在栓塞手术12h内,研究组采用行腰大池引流术,对照组行腰椎穿刺术引流脑脊液。对两组患者并发症的情况、不同时间段血流速度及脑脊液红细胞数量、颅内压水平进行比较。结果术后,研究组的脑血管痉挛、颅内感染等并发症发生率明显低于对照组,差异显著(P<0.05);对栓塞一周及两周后两组患者的血液流速情况进行观察,研究组的的血液流速改善情况明显优于对照组,有统计学差异(P<0.001);两组患者不同时间段的脑脊液红细胞数量及颅内压水平进行比较,以研究组改善更为显著,比较有统计学意义(P<0.001)。结论在破裂颅内动脉瘤介入治疗后行早期持续腰池引流,可显著降低脑血管痉挛、积血及感染等并发症的发生,稳定血流速度,促近患者康复,具有较好的临床疗效,值得进一步的推广应用。

Objective To evaluate the clinical value of early continuous lumbar cistern drainage after interventional treatment of ruptured intracranial aneurysms. Methods 78 patients with ruptured intracranial aneurysms were randomly divided into control group (39 cases)and study group(39 cases). The patients in the study group were treated with lumbar cistern drainage,and cerebrospinal fluid drainage with lumbar puncture was applied in the control group within 12 hours of embolization. The complications,blood flow velocity,cerebrospinal fluid erythrocyte count and intracranial pressure were compared between the two groups. Results Complica tions,such as cerebral vasospasm and intracranial infection after operation,occurred in the study group were significant lower than the control group(P<0.05). After one week and two weeks of embolization,the blood flow velocity of the two groups was observed. The improvement of the blood flow velocity in the study group was significantly better than that in the control group(P<0.001). The number of cerebrospinal fluid erythrocytes and the level of intracranial pressure in the two groups were significantly improved in the study group. There was statistically significant difference(P<0.001). Conclusion Early sustained lumbar cistern drainage after inter ventional treatment of ruptured intracranial aneurysms can significantly reduce cerebral vasospasm,hemorrhage and infection. The oc currence of the disease,the stabilization of the blood flow velocity and the rehabilitation of the patients have good clinical effect and are worthy of further popularization and application.