腰大池-腹腔分流术治疗动脉瘤性蛛网膜下腔出血后慢性脑积水的效果

Effect of lumbar cistern-peritoneal shunt in the treatment of chronic hydrocephalus after aneurysmal subarachnoid hemorrhage

目的探讨腰大池-腹腔分流术治疗动脉瘤性蛛网膜下腔出血后慢性脑积水的效果。方法选取本院收治的122例动脉瘤性蛛网膜下腔出血后慢性脑积水患者为研究对象,根据手术方式不同将其分为参照组和研究组,各61例。参照组开展脑室-腹腔分流术治疗,研究组开展腰大池-腹腔分流术治疗。比较两组的治疗效果。结果研究组的治疗总有效率高于参照组(P<0.05)。研究组的并发症总发生率低于参照组(P<0.05)。研究组的手术时间、术后拔管时间、住院时间短于参照组(P<0.05)。术后1个月,研究组的美国国立卫生院卒中量表(NIHSS)评分低于参照组,日常生活活动能力量表(ADL)、简易精神状态量表(MMSE)及Fugl-Meyer运动功能评定量表(FMA)评分高于参照组(P<0.05)。术后1个月,研究组的S100β蛋白及神经元特异性烯醇化酶(NSE)水平低于参照组(P<0.05)。结论腰大池-腹腔分流术治疗动脉瘤性蛛网膜下腔出血后慢性脑积水的效果较好,其可改善患者的肢体、神经功能及精神状态,提高日常生活能力,且安全性好。

Objective To explore the effect of lumbar cistern-peritoneal shunt in the treatment of chronic hydrocephalus after aneurysmal subarachnoid hemorrhage.Methods A total of 122 patients with chronic hydrocephalus after aneurysmal subarachnoid hemorrhage admitted in our hospital were selected as the research objects.According to different surgical methods,the patients were divided into reference group and study group,with 61 cases in each group.The reference group was treated with ventriculoperitoneal shunt,and the study group was treated with lumbar cistern-peritoneal shunt.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the study group was higher than that in the reference group(P<0.05).The total incidence of complications in the study group was lower than that in the reference group(P<0.05).The operation time,postoperative extubation time and hospitalization time of the study group were shorter than those of the reference group(P<0.05).One month after operation,the National Institutes of Health Stroke Scale(NIHSS)score of the study group was lower than that of the reference group,and the Activities of Daily Living Scale(ADL),the Mini-Mental State Examination(MMSE)and Fugl-Meyer Assessment(FMA)scores were higher than those of the reference group(P<0.05).One month after operation,the levels of S100βprotein and neuron-specific enolase(NSE)in the study group were lower than those in the reference group(P<0.05).Conclusion Lumbar cistern-peritoneal shunt is effective in the treatment of chronic hydrocephalus after aneurysmal subarachnoid hemorrhage.It can improve the limb,nerve function and mental state of patients,and improve the ability of daily living,with good safety.