早期腰大池持续引流用于改善老年动脉瘤性蛛网膜下腔出血患者脑血管痉挛的效果

Effects of early continuous drainage of lumbar cistern on cerebral vasospasm in elderly patients with aneurysmal subarachnoid hemorrhage

目的探究早期腰大池持续引流改善老年动脉瘤性蛛网膜下腔出血患者脑血管痉挛的效果。方法回顾性分析2018年8月-2020年8月广元市中心医院收治的150例老年动脉瘤性蛛网膜下腔出血患者的临床资料,根据不同的治疗方法分为对照组(n=70)和观察组(n=80)。观察组予以早期腰大池持续引流治疗,对照组予以常规腰椎穿刺治疗。观察2组治疗后的脑血管痉挛程度、头痛评分、格拉斯哥预后评分(GOS)、大脑中动脉(MCA)流速及并发症情况。结果术后3 d,观察组的脑血管痉挛发生率较对照组明显较低(P<0.05)。术后3周时,观察组的头痛评分和GOS评分明显优于对照组,且观察组术后的MCA流速较对照组明显下降(P<0.05)。观察组术后3周时的脑积水、脑梗死及再出血等并发症发生率较对照组明显较低(P<0.05)。结论老年动脉瘤性蛛网膜下腔出血患者行早期腰大池持续引流治疗,能够改善脑血管痉挛、缓解疼痛、降低并发症,具有一定临床应用价值。

Objective To explore the effects of early continuous drainage of lumbar cistern on cerebral vasospasm in elderly patients with aneurysmal subarachnoid hemorrhage.Methods The clinical data of 150 patients with aneurysmal subarachnoid hemorrhage admitted to the Central Hospital of Guangyuan City from August 2018 to August 2020 were retrospectively analyzed.The patients were divided into control group(n=70)and observation group(n=80)according to different treatment methods.The observation group was treated with early continuous drainage of lumbar cistern,and the control group was treated with conventional lumbar puncture.The degree of cerebral vasospasm,headache score,Glasgow Outcome Scale(GOS)score,middle cerebral artery(MCA)flow rate and incidence of complications of the two groups after treatment were observed and compared.Results Three days after operation,the incidence of cerebral vasospasm in the observation group was significantly lower than that in the control group(P<0.05).At 3 weeks after surgery,the headache score and GOS score of the observation group were significantly better than those of the control group,and the MCA flow rate of the observation group was significantly lower than that of the control group(P<0.05).At 3 weeks after surgery,the incidence of complications such as hydrocephalus,cerebral infarction and rebleeding in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Early continuous drainage of lumbar cistern in elderly patients with aneurysmal subarachnoid hemorrhage can improve cerebral vasospasm,relieve pain and reduce complications,which has certain clinical application value.