血管内治疗颅内动脉瘤术后发生急性脑积水的危险因素及处理

目的 可能危险因素进行Logistic多元回归分析.结果 Hunt-Hess分级和早期腰池持续置管引流为颅内动脉瘤血管内介入治疗后并发急性脑积水的最重要影响因素.结论 颅内动脉瘤血管内介入治疗后早期选择腰大池蛛网膜下腔持续引流,可预防急性脑积水发生,该方法可避免脑室穿刺,起到治疗急性脑积水的作用.

Risk factors and treatments related to acute hydrocephalus after performing endovascular embolization in patients with intracranial aneurysms

Objective To investigate the risk factors and treatments related to acute hydrocephalus after performing endovascular embolization in patients with intracranial aneurysms.Methods The data of 36 patients suffering from spontaneous subarachnoid hemorrhage (SAH) were retrospectively analyzed. Nine patients with intracranial anenrysms occurred acute communicative hydrocephalus following endovascular embolization were chose as patient group. And the other 27 patients with intracranial aneurysms without post-operative acute communicative hydrocephalus were included in control group. Possible risk factors were Hunt-Hess grade, Fisher grade, location of intracranial aneurysms, and lumbar subarachnoid continuous drainage; logistic regression analysis was performed on these factors. Results Hunt-Hess grade and lumbar subarachnoid continuous drainage were the most important factors that had effects on hydrocephalus following endovascular embolization in patients with intracranial aneurysms. Hunt-Hess grade was a risk factor (OR=14.54; 95% C.I:1.33-158.95), while lumbar suharachnoid continuous drainage was a protective factor (B=-3.198; OR=0.04; 95% C.I: 0.00-0.44). Conclusion Early lumbar subarachnoid continuous drainage, a clear protective factor, should be performed in the early stage of endovascular embolization for the purpose of protecting patients with intracranial anenrysms from acute hydrocephalus.