摘要
目的比较反复腰穿引流与腰大池持续引流在颅内动脉瘤介入栓塞术后的应用效果。方法选择许昌市人民医院2020年1月至2022年6月收治的72例行介入栓塞术治疗的颅内动脉瘤患者为研究对象,按照随机数字表法分为腰椎穿刺组与腰大池引流组,每组36例。腰椎穿刺组术后行反复腰椎穿刺引流,腰大池引流组术后行腰大池持续引流。术后定期复查颅脑CT,比较两组治疗效果,应用蒙特利尔认知评估量表(MoCA)评估两组认知功能,随访6个月,统计两组预后状况。结果腰大池引流组颈强直持续时间、血性脑脊液清除时间、头痛缓解时间、脑脊液压力恢复正常时间以及住院时间均短于腰椎穿刺组,差异均有统计学意义(P<0.05)。腰大池引流组脑积水及症状性脑血管痉挛发生率均低于腰椎穿刺组,差异有统计学意义(P<0.05)。腰大池引流组术后第7天Fisher分级优于腰椎穿刺组,差异有统计学意义(P<0.05)。腰大池引流组术后认知障碍发生率低于腰椎穿刺组,MoCA得分高于腰椎穿刺组,差异均有统计学意义(P<0.05)。腰大池引流组GOS预后良好率高于腰椎穿刺组,差异有统计学意义(P<0.05)。两组均未出现严重不良反应。结论腰大池持续引流能在短时间内引出蛛网膜下腔积血,降低相关并发症,保护患者脑神经功能。
Objective To compare the application effects of repeated lumbar puncture and continuous lumbar cistern drainage on patients undergoing interventional embolization of intracranial aneurysms.Methods Seventy-two patients with intracranial aneurysms underwent interventional embolization therapy in the People's Hospital of Xuchang from January 2020 to June 2022 were enrolled,and randomly divided into two groups,with 36 cases in each group.The lumbar puncture group received repeated lumbar puncture,and lumbar cistern drainage group received continuous lumbar cistern drainage.The cranial CT was reviewed regularly after the operation,and the treatment effects were compared between the two groups.The Montreal cognitive assessment scale(MoCA)was used to assess the cognitive function of the two groups,and the prognosis of the two groups was recorded at a 6-month follow-up.Results The duration of neck stffness,bloody cerebrospinal fluid clearance time,headache relief time,recovery time of cerebrospinal fluid pressure and hospital stay of lumbar cistern drainage group were significantly shorter than those of lumbar puncture group,with signicant diferences(P<0.05).The incidence of hydrocephalus and symptomatic cerebral vasospasm in lumbar cistern drainage group was lower than that in lumbar puncture group(P<0.05).The Fisher grade in lumbar cistern drainage group was better than that in lumbar puncture drainage group on the 7th day after operation(P<0.05).The incidence of postoperative cognitive impairment in lumbar cistern drainage group was lower than that in lumbar puncture group,and the average score of MOCA was higher than that in lumbar puncture group(all P<O.05).The good prognosis rate in Clasgow Outcome Score(COS)was significantly higher in lumbar cistern drainage group than that in lumbar puncture group(P<0.05).No serious adverse reactions were observed in either group.Conclusions Application of continuous lumbar cistern drainage can effectively clean off subarachnoid hematocele,reduce the incidence of complications,an
作者
苏志辉
冯才政
赵林
Su Zhihui;Feng Caizheng;Zhao Lin(Department of ICU,the People's Hospital of Xuchang,Xuchang 461000,China;Department of Neurosurgery,the People's Hospital of Xuchang,Xuchang 461000,China;Operating Room,the People's Hospital of Xuchang,Xuchang 461000,China)
出处
《临床医学》
CAS
2023年第9期25-28,共4页
Clinical Medicine
关键词
反复腰穿刺引流
腰大池持续引流
颅内动脉瘤
介入栓塞术
蒙特利尔认知评估表
Repeated lumbar puncture
Continuous lumbar cistern drainage
Intracranial aneurysm
Interventional embolization therapy
Montreal cognitive assessment
