脑动脉瘤夹闭后脑脊液引流对脑血流参数的影响

发布时间：2019-02-09 16:24

【摘要】：目的:探讨脑动脉瘤合并蛛网膜下腔出血患者接受动脉瘤夹闭术后,行脑脊液引流对脑血流参数的影响及临床意义。方法:纳入2013年1月至2016年9月我院收治的82例脑动脉瘤合并蛛网膜下腔出血患者,随机均分为观察组、对照组各41例,均接受动脉瘤夹闭术,观察组术后接受脑脊液引流,对照组术后直接缝合硬脑膜。对比2组术前、术后7 d时术侧大脑中动脉血流动力学参数,并发症发生情况。结果:术前2组各血流动力学参数差异无统计学意义(P0.05);术后7 d观察组收缩期血流峰速度、平均血流速度、舒张期血流峰速度、搏动指数、阻力指数均明显低于对照组,差异有统计学意义(P0.05)。观察组术后2、4、7 d,脑脊液红细胞计数明显低于对照组,差异有统计学意义(P0.05)。观察组脑积水、脑血管痉挛发生率明显低于对照组,差异有统计学意义(P0.05)。结论:脑动脉瘤夹闭后脑脊液引流有助于降低脑血管血流速度,这可能是其对术后脑积水及脑血管痉挛的预防机制之一。
[Abstract]:Objective: to investigate the effect of cerebrospinal fluid drainage on cerebral blood flow parameters in patients with cerebral aneurysm complicated with subarachnoid hemorrhage. Methods: from January 2013 to September 2016, 82 patients with cerebral aneurysm complicated with subarachnoid hemorrhage were randomly divided into two groups: the control group (n = 41) and the control group (n = 41). In the control group, the dura mater was sutured directly after operation. The hemodynamic parameters and complications of the middle cerebral artery were compared between the two groups before and 7 days after operation. Results: there was no significant difference in hemodynamic parameters between the two groups before operation (P0.05). The peak systolic velocity, mean blood flow velocity, diastolic peak velocity, pulsatility index and resistance index in the observation group were significantly lower than those in the control group 7 days after operation (P0.05). The erythrocyte count of cerebrospinal fluid in the observation group was significantly lower than that in the control group at 7 days after operation (P0.05). The incidence of hydrocephalus and cerebral vasospasm in the observation group was significantly lower than that in the control group (P0.05). Conclusion: cerebrospinal fluid drainage after clipping cerebral aneurysm may be one of the preventive mechanisms of cerebral hydrocephalus and cerebral vasospasm after operation.
【作者单位】：河北省邢台市人民医院神经外二科;
【基金】：河北医学科技项目(编号:152574-5-5)
【分类号】：R651.12

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