腰大池持续引流在动脉瘤性蛛网膜下腔出血术后的临床应用

目的 探讨腰大池持续引流在动脉瘤性蛛网膜下腔出血(SAH)术后的临床应用效果.方法 选择本院2012年1月至2015年4月动脉瘤性SAH患者94例,根据入院编号按照单双号随机分为对照组和观察组各47例,对照组患者术后行腰椎穿刺引流;观察组患者术后行腰大池持续引流,比较两组患者的临床疗效及并发症发生情况.结果 观察组患者的治疗总有效率为80.85%(38/47),高于对照组的65.96%(31/47),差异有统计学意义(P<0.05);观察组患者的颅内压恢复正常时间和头痛缓解时间分别为(12.83±2.19)d和(11.69±2.25)d,均低于对照组的(16.45±2.37)d和(14.70±2.41)d,差异均有统计学意义(P<0.05);观察组患者的脑血管痉挛和脑积水发生率分别为23.40%(11/47)和17.02%(8/47),均低于对照组的40.43%(19/47)和27.66%(13/47),差异均有统计学意义(P<0.05);观察组患者的脑血流速度(Vm)、视觉模拟评分法(VAS)和格拉斯哥预后评分(GOS)评分结果分别为(129.61±13.45)cm/s、(3.63±0.38)分和(4.21±0.19)分,均低于对照组的(163.83±14.20)cm/s、(4.47±0.40)分和(5.95±0.22)分,差异均有统计学意义(P<0.05).结论 腰大池持续引流在动脉瘤性SAH术后应用具有较好的临床疗效,能够显著降低患者的并发症,缩短患者恢复时间,预后较好.

Clinical application of continuous lumbar drainage in patients with aneurysmal subarachnoid hemorrhage after operation

Objective To explore the application effect of continuous lumbar drainage in patients with aneurys-mal subarachnoid hemorrhage (SAH). Methods Ninety-four patients with aneurysmal SAH in our hospital from Janu-ary 2012 to April 2015 were selected and randomly divided into the control group and observation group according to ad-mission order of odd and even number, with 47 patients in each group. Patients in the control group underwent lumbar puncture and drainage, and the observation group was performed continuous lumbar drainage. The clinical efficacy and complications between two groups were compared. Results The total effective rate of the observation group was signif-icantly higher than that of control group 80.85%(38/47) vs 65.96%(31/47), P<0.05)]. The time for intracranial pressure to restore the normal and headache relief time of the observation group were significantly lower than those of control group (12.83 ± 2.19) d vs (16.45 ± 2.37) d, (11.69 ± 2.25) d vs (14.70 ± 2.41) d, P<0.05]. The incidences of cerebral vaso-spasm and hydrocephalus of the observation group were significantly lower than those of control group 23.40%(11/47) vs 40.43%(19/47), 17.02%(8/47) vs 27.66%(13/47), P<0.05]. The cerebral blood flow velocity (Vm),Visual Analogue Scale (VAS) and Glasgow Prognostic Score (GCS) results of the observation group were significantly lower than those of control group (129.61±13.45) cm/s vs (163.83±14.20) cm/s, (3.63±0.38) vs (4.47±0.40), (4.21±0.19) vs (5.95±0.22), P<0.05]. Conclusion Continuous lumbar drainage in the treatment of aneurysmal SAH has good clinical curative ef-fect, which can significantly reduce the patient's complications, shorten the recovery time, and improve the prognosis.