摘要
目的探讨动脉瘤性蛛网膜下腔出血(aSAH)后正常颅压脑积水(NPH)临床表现与处理。方法分析aSAH后NPH手术治疗的15例患者病历资料,男性6例,女9例,平均年龄(57.00±8.25)岁,aSAH发病时Hunt-Hess分级II级6例,III级6例,IV级3例,动脉瘤均行开颅手术夹闭,出现脑积水症状的时间分别为术后1个月4例,2个月9例,3个月2例。再次入院后均行腰穿放脑脊液试验(Tap试验),腰穿测压在70~180mmH_2O(1mmH_2O=0.0098kPa),Tap试验阳性13例,阴性2例,均应用可调压分流系统行脑室-腹腔分流术。结果术后随访1年,临床症状治愈12例,好转1例,无效2例。结论关注aSAH后正常颅压脑积水发生的高危因素,一旦确诊脑积水,应及时采取可调压分流系统行脑室-腹腔分流术,一般可获得满意的临床效果。
Objective To investigate the effect of ventriculo-peritoneal shunt in normal pressure hydrocephalus(NPH)patients with aneurysmal subarachnoid hemorrhage(aSAH).Method The clinical characteristics,imaging data,diagnosis and treatment strategy were analyzed in 15 patients with INH retrospectively.Hunt-Hess grade II were 6,grade III were 6 and grade IV were 3 according to patients condition after hospitalized.All of patients received surgical clipping.Symptoms of hydrocephalus were presented post-operation one month for 4 cases,two months for 9 cases and three months for 2 cases.Lumbar puncture fluid experiments(Tap test)were carried out after readmission.The pressure were 70-180mmH2O.Tap test were positive for 13 cases and negative for 2 case.Adjustable pressure diversion system were applied in ventriculo-peritoneal shunt operation.Results Clinical symptoms were significantly improved for 12 cases,fair for 1 case and invalid 2 cases after one year following up.Conclusion ventriculo-peritoneal shunt operation should be done as soon as possible for INH patients with aneurysmal subarachnoid hemorrhage if the risk factor exsiting.The patients would be good prognosis under the suitable treatment measures.
作者
梁朝辉
郭二坤
米中波
彭立威
吕中强
王立群
Liang Chaohui;Guo Erkun;Mi Zhongbo;Peng Liwei;Lv Zhongqiang;Wang Liqun(Department of Neurosurgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)
出处
《脑与神经疾病杂志》
2018年第5期268-271,共4页
Journal of Brain and Nervous Diseases
基金
河北省医学科学研究重点课题计划(20150220)
关键词
颅内动脉瘤
蛛网膜下腔出血
正常颅压脑积水
脑室-腹腔分流术
Intracranial aneurysm
Subarachnoid hemorrhage
Normal pressure hydrocephalus
Ventriculoperitoneal shunt
