第三脑室终板造瘘联合单纯动脉瘤夹闭治疗动脉瘤性蛛网膜下腔出血后脑积水的效果

Effects of third ventricle endplate fistulation combined with simple aneurysm clipping in the treatment of patients with hydrocephalus after aneurysmal subarachnoid hemorrhage

目的:探讨第三脑室终板造瘘(FLT)联合单纯动脉瘤夹闭治疗动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage aSAH)后脑积水的效果。方法:112例动脉瘤性蛛网膜下腔出血后脑积水患者,依据随机数表法分为两组,每组56例。观察组行单纯动脉瘤夹闭手术,观察组在对照组的基础上实施第三脑室FLT治疗。术后均随访5个月,分析两组的治疗有效率、格拉斯哥预后评分(GOS)和术后并发症。结果:观察组治疗总有效率92.8%,高于对照组78.6%(P<0.05);GOS评分(4.2±0.4),高于对照组(3.5±0.6)(P<0.05);观察组并发症发生率23.21%,低于对照组42.86%(P<0.05)。结论:第三脑室FLT联合单纯动脉瘤夹闭治疗aSAH脑积水能提高治疗有效率,减少并发症。

Objective:To invesitigate the efficacy of third ventricle endplate fistulation(FLT)combined with simple aneurysm clipping in the treatment of hydrocephalus after aneurysmal subarachnoid hemorrhage(aSAH).Methods:112 patients with hydrocephalus after aneurysmal subarachnoid hemorrhage were randomized into two groups,with 56 cases in each group.The control group were treated with simple aneurysm clipping operation,while the observation group were treated with FLT of the third ventricle on the basis of treatment for the control group.Then,the treatment effect,Glasgow Outcome Score(GOS)and postoperative complications of the two groups were compared after 5 months of follow-up.Results:The total effective rate of the observation group was 92.8%,which was higher than 78.6%of the control group(P<0.05);GOS score of the observation group was(4.2±0.4),higher than(3.5±0.6)of the control group(P<0.05);and the incidence of complications in the observation group was 23.21%,which was lower than 42.86%in the control group(P<0.05).Conclusion:The third ventricle FLT combined with simple aneurysm clipping is effective in the treatment of patients with hydrocephalus after aSAH,which can significantly reduce the incidence of complications in patients.