摘要
【目的】探讨动脉瘤夹闭术后腰大池引流联合高血压、高血容量及血液稀释（3H）治疗蛛网膜下腔出血的效果及对血管活性因子的影响。【方法】选取2016年5月至2017年5月本院收治的蛛网膜下腔出血患者116例，随机分为对照组及观察组两组各58例，对照组应用动脉瘤夹闭术后腰大池引流治疗，观察组在对照组基础上联合3H治疗。比较两组患者治疗效果、术后并发症、血清C反应蛋白（CRP）及S100水平及血浆舒张因子（NO）、收缩因子（ET-1）、血栓素B2（TXB2）及人6-酮-前列环素F1d（6-K-PGF1α）水平变化。【结果】观察组治疗有效率为93．1％，明显高对照组的70．4％（P〈0.05）；观察组患者头痛评分、脑血管痉挛程度明显低于对照组（P〈0．05），颅脑积水及死亡率明显低于对照组（P〈0．05）。干预前，两组患者血清CRP、S100水平及血浆N0、ET-1、TXB2及6-K-PGF1α水平比较无明显差异（P〉0．05）；干预后，观察组各指标明显低于对照组（P〈0．05）。【结论】动脉瘤夹闭术后腰大池引流联合3H治疗蛛网膜下腔出血安全可靠，可减少患者并发症并保证存活率，治疗效果更为理想，值得临床推广应用。
[Objective] To study the clinical effect of lumbar cistern drainage combined with hypertension, high blood volume and hemodilution （3H） on subarachnoid hemorrhage after aneurysm clipping operation and its effect on vasoactive factors. [Methods]From May 2016 to May 2017, 116 patients with subarachnoid hem- orrhage were randomly divided into two groups： the control group （n = 58） and the observation group （ n 58）. The control group was treated with lumbar cistern drainage after aneurysm clipping. The observation group combined with 3 H therapy on the basis of the control group. The therapeutic effects, postoperative complications, serum C-reactive protein （CRP） and S100 levels, plasma diastolic factor （NO）, contraction factor （ET-1）, thromboxane B2 （TXB2） and human 6-keto-prostacyclin （6-K-PGF1α） levels were compared between the two groups.[Results]The effective rate of treatment in the observation group was 93.1%, which was significantly higher than that in the control group 70.4% （ P〈0.05） ;the headache score and cerebral vas- ospasm in the observation group were significantly lower than those in the control group （ P 〈0.05）, and the craniocerebral hydrocephalus and mortality were significantly lower than those in the control group （ P 0.05）. Before intervention, there was no significant difference in serum CRP,S100 level and plasma NO,ET-1, TXB2 and 6-K-PGF1α levels between the two groups （ P〉0.05）, and after intervention, the indexes in the observation group were significantly lower than those in the control group （ P〈0.05）.[Conclusion] The treatment of subarachnoid hemorrhage by lumbar cistern drainage combined with 3H after aneurysm clipping is safe and reliable. It can reduce complications and ensure survival rate.
作者
陈绍华
CHEN Shao-hua(Neurology,Leshan geriatric hospital,Leshan,Sichuan,614000)
出处
《医学临床研究》
CAS
2018年第9期1723-1726,共4页
Journal of Clinical Research
