本文選題：腰大池持續(xù)外引流 + 動脈瘤栓塞�。� 參考：《廣西醫(yī)科大學》2015年碩士論文

【摘要】：目的：分析動脈瘤性蛛網(wǎng)膜下腔出血(aSAH)在動脈瘤栓塞治療后采用腰大池持續(xù)外引流的療效。方法：回顧性分析2008年8月-2013年8月廣西醫(yī)科大學第一附屬醫(yī)院神經外科收治的75例顱內動脈瘤破裂并蛛網(wǎng)膜下腔出血患者的資料,其中35例在其動脈瘤介入栓塞后24h內行腰大池持續(xù)外引流,該組設為治療組；另外40例在動脈瘤栓塞后常規(guī)行腰椎穿刺術,設為對照組。比較兩組患者術后頭痛時間、術后1周GCS評分改善情況、術后第3天及第7天Fisher評分改善情況、癥狀性腦血管痙攣發(fā)生率、術后3周腦積水發(fā)生率及GOS評分良好率。結果：治療組頭痛時間明顯縮短(P0.01)；術后1周治療組GCS評分改善優(yōu)于對照組(P0.05)；術后第3天及第7天Fisher評分改善明顯優(yōu)于對照組(P0.01)；治療組癥狀性腦血管痙攣及腦積水發(fā)生率低于對照組(P0.05)；術后3周GOS評分良好率治療組高于對照組(P＜0.05)。結論：aSAH患者在動脈瘤栓塞治療后早期采用腰大池持續(xù)外引流能較快改善患者頭痛癥狀；短期內GCS評分改善明顯；蛛網(wǎng)膜下腔中積血清除速度明顯加快；降低了腦血管痙攣與腦積水發(fā)生率；改善患者預后與生存質量。
[Abstract]:Objective: to analyze the effect of continuous external drainage of lumbar cistern after embolization of aneurysm with aneurysm subarachnoid hemorrhage (aSAH). Methods: from August 2008 to August 2013, 75 patients with ruptured intracranial aneurysms and subarachnoid hemorrhage in the Neurosurgery Department of the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. 35 cases were treated with lumbar cistern continuous external drainage within 24 hours after embolization of aneurysms, the other 40 cases were treated with lumbar puncture after embolization of aneurysms, as control group. The time of headache, the improvement of GCS at 1 week after operation, the improvement of Fisher score on the 3rd and 7th day after operation, the incidence of symptomatic cerebral vasospasm, the incidence of hydrocephalus 3 weeks after operation and the good rate of GOS score were compared between the two groups. Results: the headache time of the treatment group was significantly shortened (P0.01), the GCS score of the treatment group was improved better than that of the control group at 1 week after operation (P0.05), the Fisher score of the treatment group was significantly better than that of the control group on the 3rd and 7th day after operation (P0.01). The incidence of symptomatic cerebral vasospasm and hydrocephalus in the treatment group was lower than that in the control group (P0.05), and the good GOS score rate in the treatment group was higher than that in the control group 3 weeks after operation (P < 0.05). Conclusion continuous external drainage of lumbar cistern can improve headache symptoms in early stage after embolization of aneurysms, improve GCS score significantly in short term, and accelerate the clearance rate of subarachnoid hemorrhage in the early stage after embolization of aneurysms. It reduces the incidence of cerebral vasospasm and hydrocephalus and improves the prognosis and quality of life.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R651.12

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