本文選題：動(dòng)脈瘤性蛛網(wǎng)膜下腔出血　切入點(diǎn)：慢性腦積水　出處：《河北醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察腰大池-腹腔分流術(shù)(lumboperitoneal shunt,LPS)與腦室-腹腔分流術(shù)(ventriculoperitoneal shunt,VPS)治療動(dòng)脈瘤性蛛網(wǎng)膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)后慢性腦積水(chronic hydrocephalus)臨床效果,并進(jìn)行比較,進(jìn)一步提高治療水平,改善預(yù)后,為臨床選擇合適手術(shù)方法提供相關(guān)依據(jù)。方法:選取2009年6月至2014年6月河北醫(yī)科大學(xué)第二附屬醫(yī)院神經(jīng)外科治療的動(dòng)脈瘤性蛛網(wǎng)膜下腔出血(aSAH)后慢性交通性腦積水患者36例,其中行LPS治療的18例患者為治療組,行VPS治療的18例患者為對(duì)照組,比較術(shù)后兩組的療效、并發(fā)癥發(fā)生率及手術(shù)前后格拉斯哥昏迷評(píng)分(Glasgow Coma Scale,GCS),從而評(píng)價(jià)兩種術(shù)式在治療aSAH后慢性腦積水的臨床效果。結(jié)果:術(shù)后隨訪6個(gè)月,治療組總有效率(94.5%)高于對(duì)照組(77.8%),差異有統(tǒng)計(jì)學(xué)意義(χ2=4.433,P0.05),治療組并發(fā)癥發(fā)生率(11.1%)低于對(duì)照組(44.4%),差異有統(tǒng)計(jì)學(xué)意義(χ2=4.985,P0.05)。治療組手術(shù)前后GCS評(píng)分分別為(10.6±2.9)分、(12.9±2.2)分,對(duì)照組手術(shù)前后GCS評(píng)分分別為(10.5±2.4)分、(12.2±2.1)分,兩組患者術(shù)前GCS評(píng)分無(wú)明顯差異(t=0.126,P0.05),術(shù)后GCS評(píng)分均提高,但治療組術(shù)后GCS評(píng)分提高更明顯(t=1.935,P0.05)。結(jié)論:LPS治療aSAH后慢性腦積水較VPS具有更良好的臨床效果,并發(fā)癥發(fā)生率低,且GCS評(píng)分提高更明顯。
[Abstract]:Objective: to observe the clinical effects of lumbar cisternoceliac shunt#en0# (LPSs) and ventriculoperitoneal shunttor (VPSs) in the treatment of chronic hydrocephalus after aneurysm subarachnoid hemorrhage (SAH), and to compare and compare the clinical effects of LPSs and VPSs in the treatment of chronic hydrocephalus after aneurysm subarachnoid hemorrhage (SAH). Methods: from June 2009 to June 2014, 36 patients with chronic communicating hydrocephalus were treated by neurosurgery in the second affiliated Hospital of Hebei Medical University. Among them, 18 patients treated with LPS and 18 patients treated with VPS were treated as control group. The curative effects of the two groups were compared. The incidence of complications and Glasgow Coma scale scale before and after operation were evaluated to evaluate the clinical effect of the two methods in the treatment of chronic hydrocephalus after aSAH. The total effective rate of the treatment group was significantly higher than that of the control group (蠂 2 443 3 P 0.05, P 0.01), and the difference was statistically significant compared with that of the control group (蠂 2 + 4.98 5 P 0.05). The GCS score before and after operation in the treatment group was 10. 6 鹵2. 9 and 12.9 鹵2. 2, respectively, which was significantly lower than that in the control group (P 0. 05), and the incidence of complications in the treatment group was significantly lower than that in the control group (P 0. 05), and the difference was statistically significant (蠂 2 + 4. 98 5 + P 0. 05). The GCS score before and after operation in the control group was 10.5 鹵2.4 and 12.2 鹵2.1, respectively. There was no significant difference in preoperative GCS score between the two groups. The GCS score increased after operation. However, the GCS score of the treatment group was significantly higher than that of the control group (P 0.05). Conclusion the treatment of chronic hydrocephalus with aSAH has a better clinical effect than that of VPS, and the incidence of complications is lower, and the GCS score is more obvious.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R651.1

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本文編號(hào)：1611503