蛛网膜下腔出血动脉瘤夹闭术前早期持续腰池引流的临床分析

目的探讨动脉瘤性蛛网膜下腔出血（aSAH）行动脉瘤夹闭术前早期持续腰池引流对患者并发症的发生及预后的影响。方法回顾性研究收集2010年1月至2013年1月320例aSAH患者行持续腰池引流后接受动脉瘤夹闭手术治疗患者的病例资料,并与未行引流治疗的200例同期患者的病例资料进行对照研究。探讨两组患者的预后、并发症差别。结果持续腰池引流组患者预后较对照组明显提高（P=0.011）,显著降低动脉瘤夹闭术后脑积水（χ2=11.10,P=0.01）、迟发性缺血性神经功能障碍（χ2=4.86,P=0.03）以及颅内感染的发生率（χ2=0.39,P=0.53）。结论对于aSAH患者夹闭术前早期行持续腰池引流治疗是较合理的选择,对改善患者预后及减少并发症的发生具有重大意义。

Clinical analysis of early continuous lumbar cisterna drainage before clipping in patients with aneurysmal subarachnoid hemorrhage

Objective To evaluate the influence of early continuous lumbar cistema drainage before dipping on patients＇ complications and recovery with aneurysmal subarachnoid hemorrage. Methods A retrospective study of 320 cases of ruptured aneurysm undergo continuous lumbar cisterna drainage before operation from January 2010 to January 2013 in the hospital, and to compare them with 200 cases with no continuous lumbar cisterna drainage at the same period.To discuss the differences on recovery and complications of the two groups. Results Compared with the no-drainage group, the continuous lumbar cisterna drainage group showed significant progress in recovery （P〈0.05）, and significantly reduced the occurance rates of cerebral vasospasm, delayed ischemic neurological deficit（DIND） and intracranial infection. It did＇t increase the risk of intracranial infection（P〉0.05）. Conclusion It＇s a reasonable choice to undergo continuous lumbar cisterna drainage before aneurysm clipping. It can effectively improve the outcome and reduce the occurance of complications.