腰大池引流在预防颅内动脉瘤破裂术后脑血管痉挛发生中的应用价值.docxVIP

腰大池引流在预防颅内动脉瘤破裂术后脑血管痉挛发生中的应用价值 　　摘要：目的分析腰大池引流在预防颅内动脉瘤破裂术后脑血管痉挛发生中的应用价值。方法回顾性分析2017年4月～2019年4月我院收治的90例颅内动脉瘤破裂患者临床资料，根据治疗方式不同分为观察组（50例）和对照组（40例）。观察组早期给予腰大池持续引流脑脊液治疗，对照组早期给予间断腰椎穿刺释放脑脊液治疗，比较两组术后24h、6d、10d颅内压、脑脊液红细胞计数;随访3个月，比较两组脑血管痉挛发生率、脑积水发生率。结果术后24h，两组颅内压及脑脊液红细胞计数比较，差异无统计学意义（p0.05）;术后6、10d，两组颅内压及脑脊液红细胞计数均较术后24h下降，且观察组低于对照组，差异有统计学意义（p0.05）;观察组脑血管痉挛和脑积水发生率分别为4.00%、2.00%，低于对照组的20.00%、15.00%，差异有统计学意义（p0.05）。结论在颅内动脉瘤破裂患者中早期应用腰大池持续引流脑脊液，可以有效降低颅内压力，减少脑脊液红细胞计数，降低脑血管痉挛和脑积水发生率。 　　关键词：颅内动脉瘤;脑血管痉挛;腰大池引流;腰椎穿刺 　　中图分类号：r743文献标识码：adoi：10.3969/j.issn.1006-1959.2020.05.034 　　文章編号：1006-1959（2020）05-109-03 　　abstract：objectivetoanalyzetheapplicationvalueoflargelumbardrainageinthepreventionofcerebralvasospasmafterintracranialaneurysmrupture.methodstheclinicaldataof90patientswithintracranialaneurysmruptureadmittedinourhospitalfromapril2017toapril2019wereretrospectivelyanalyzed.theyweredividedintoobservationgroup（50cases）andcontrolgroup（40cases）accordingtodifferenttreatmentmethods.theobservationgroupwastreatedwithcontinuousdrainageofcerebrospinalfluidattheearlystageofthelumbargreatpond，andthecontrolgroupwastreatedwithintermittentlumbarpuncturetoreleasecerebrospinalfluidattheearlystage.theintracranialpressureandcerebrospinalfluidredbloodcellcountwerecomparedat24h，6d，and10daftersurgeryinthetwogroups.follow-upfor3months，theincidenceofcerebralvasospasmandhydrocephaluswerecomparedbetweenthetwogroups.resultsat24hafteroperation，therewasnosignificantdifferenceinintracranialpressureandcerebrospinalfluidredbloodcellcountsbetweenthetwogroups（p0.05）.at6and10dafteroperation，intracranialpressureandcerebrospinalfluidredbloodcellcountsdecreasedinbothgroupscomparedwith24haftersurgery.andtheobservationgroupwaslowerthanthecontrolgroup，thedifferencewasstatisticallysignificant（p0.05）;theincidenceofcerebralvasospasmandhydrocephalusintheobservationgroupwere4.00%and2.00%，whichwerelowerthanthecontrolgroups20.00%and15.00%，thedifferencewasstatisticallysignificant（p0.05）.conclusionearlyapplicationof