持续腰大池引流配合超早期显微手术治疗颅内动脉瘤破裂的临床效果

Clinical effect of continuous lumbar drainage combined with ultra-early microsurgery on intracranial aneurysm rupture

目的 探讨持续腰大池引流配合超早期显微手术治疗颅内动脉瘤破裂的临床效果。方法 选择2019年2月至2022年2月商丘市第一人民医院收治的84例颅内动脉瘤破裂患者为研究对象,根据治疗方案不同分为两组,每组42例。超早期显微手术+腰穿引流为对照组,持续腰大池引流+超早期显微手术治疗为观察组。比较两组效果。结果 格拉斯哥昏迷评分评价效果显示,观察组恢复良好率高于对照组(P<0.05)。治疗后3、6、12d时观察组脑脊液压力、脑脊液红细胞数目均低于对照组(P<0.05)。治疗前两组患者神经功能比较,差异未见统计学意义(P>0.05),治疗后观察组神经功能神经功能缺损评分更低(P<0.05)。观察组并发症率低于对照组(P<0.05)。结论 颅内动脉瘤破裂患者采取持续腰大池引流+超早期显微手术治疗,可提高预后,更好地改善脑脊液压力,促进脑脊液红细胞数目降低,同时有效减少并发症发生,促使患者神经功能恢复。

Objective To investigate the clinical effect of continuous lumbar drainage combined with ultra-early microsurgery on ruptured intracranial aneurysm. Methods Eighty-four patients with ruptured intracranial aneurysms in the Shangqiu First People’s Hospital from February 2019 to February 2022 were selected for study and divided into two groups according to different treatment plans, with 42 cases in each group. Ultra-early microsurgery + lumbar puncture and drainage was given in the control group, and continuous lumbar drainage + ultra-early microsurgery was given in the observation group. The effects of the two groups were compared. Results The effect of GCS score evaluation showed that the good recovery rate of the observation group was higher than that of the control group(P<0.05). The cerebrospinal fluid pressure and the number of cerebrospinal fluid red blood cells in the observation group were lower than those in the control group at 3, 6, and 12d after treatment(P<0.05). Before treatment, there was no significant difference in neurological function(P>0.05). After treatment, the NIHSS score of neurological function was lower in the observation group, which was significantly different from the control group(P<0.05). The complication rate in the observation group was lower than that in the control group(P<0.05). Conclusions Continuous lumbar cistern drainage + ultra-early microsurgery in patients with ruptured intracranial aneurysm can improve prognosis, better improve cerebrospinal fluid pressure, reduce the number of red blood cells in cerebrospinal fluid, and effectively reduce the occurrence of complications and promote the recovery of neurological function in patients.