早期持续腰大池引流对颅内动脉瘤介入栓塞术后急性脑积水影响.docVIP

早期持续腰大池引流对颅内动脉瘤介入栓塞术后急性脑积水影响【中图分类号】R 739.4 【文献标识码】A 【文章编号】1672－3783(2011)07－0026－02 【摘要】目的：探讨早期持续腰大池引流对颅内动脉瘤栓塞术后患者并发急性脑积水的影响。方法：回顾性分析我院采用介入栓塞治疗的124例颅内动脉瘤患者资料。治疗后1d、3d和7d时头颅CT平扫评价无脑积水的发生。采用单因素和多因素Logistic回归分析腰大池引流的作用。结果：29例患者并发术后急性脑积水(23.4%)。43例腰大池引流的患者并发脑积水5例(11.6%)，而未引流的81例患者并发脑积水24例(29.6%) (χ2=5.080, P=0.024)。排除Hunt-Hess分级和脑室积血等混杂因素后，不采用早期腰大池引流的栓塞术后患者并发脑积水的机会是采用腰大池引流的3.074倍，95%CI为1.137-2.156。结论：早期持续腰大池引流可有效减少颅内动脉瘤栓塞术后患者并发急性脑积水的机会。 【关键词】颅内动脉瘤；介入；并发症；急性脑积水；腰大池引流 The reducing acute hydrocephalus effects of early continuous lumbar drainage in patients with intracranial aneurysms after embolization LI YA PING ,ZHU LING ,LIANG CHONG 【Abstract】Objective: To investigate the clinical value of early continuous lumbar drainage for reduce acute hydrocephalus in patients with intracranial aneurysms after embolization. Methods: A retrospective analysis with 124 patients of embolization for intracranial aneurysms was conducted. After embolization treatment, head CT scan for evaluation of the occurrence of hydrocephalus at postoperative 1d, 3d and 7d, respectively. We used statistics analysis by univariate and multivariate Logistic regression. Results: 29 patients had complications of postoperative acute hydrocephalus (23.4%). 5 patients (11.6%) had hydrocephalus in the group with lumbar drainage, compared with 24 patients (29.6%) in the group without lumbar drainage (χ2 = 5.080, P = 0.024). After rule out the confounding factors of Hunt-Hess grade and intraventricular hemorrhage by Logistic regression, early lumbar drainage was an independent risk factor for acute hydrocephalus in patients with intracranial aneurysms after embolization, with OR 3.074, 95% CI 1.137-2.156. Conclusion: Early continuous lumbar drainage can effectively reduce the acute hydrocephalus in patients with intracranial aneurysms after embolization. 【Key words】intracranial aneurysm; intervention; complications; acute hydrocephalus; lumbar drainage 颅内动脉瘤会导致蛛网膜下腔出血、脑内血肿以及出血后血管痉挛发生的脑梗死，有较高的