腰大池—腹腔分流术与脑室—腹腔分流术治疗动脉瘤性蛛网膜下腔出血后慢性脑积水临床效果比较

发布时间：2018-03-14 13:56

本文选题：动脉瘤性蛛网膜下腔出血　切入点：慢性脑积水　出处：《河北医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:观察腰大池-腹腔分流术(lumboperitoneal shunt,LPS)与脑室-腹腔分流术(ventriculoperitoneal shunt,VPS)治疗动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)后慢性脑积水(chronic hydrocephalus)临床效果,并进行比较,进一步提高治疗水平,改善预后,为临床选择合适手术方法提供相关依据。方法:选取2009年6月至2014年6月河北医科大学第二附属医院神经外科治疗的动脉瘤性蛛网膜下腔出血(aSAH)后慢性交通性脑积水患者36例,其中行LPS治疗的18例患者为治疗组,行VPS治疗的18例患者为对照组,比较术后两组的疗效、并发症发生率及手术前后格拉斯哥昏迷评分(Glasgow Coma Scale,GCS),从而评价两种术式在治疗aSAH后慢性脑积水的临床效果。结果:术后随访6个月,治疗组总有效率(94.5%)高于对照组(77.8%),差异有统计学意义(χ2=4.433,P0.05),治疗组并发症发生率(11.1%)低于对照组(44.4%),差异有统计学意义(χ2=4.985,P0.05)。治疗组手术前后GCS评分分别为(10.6±2.9)分、(12.9±2.2)分,对照组手术前后GCS评分分别为(10.5±2.4)分、(12.2±2.1)分,两组患者术前GCS评分无明显差异(t=0.126,P0.05),术后GCS评分均提高,但治疗组术后GCS评分提高更明显(t=1.935,P0.05)。结论:LPS治疗aSAH后慢性脑积水较VPS具有更良好的临床效果,并发症发生率低,且GCS评分提高更明显。
[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 卤2. 9 and 12.9 卤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 卤2.4 and 12.2 卤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.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1

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