摘要
目的评价蛛网膜下腔出血(SAH)患者经颅内动脉瘤(AN)介入栓塞术后,行脑脊液(CSF)置换的有效性、安全性及预后。方法选择SAH急性期患者136例,其中介入栓塞治疗组92例,经股动脉插管,应用微导管技术将微弹簧超选择血管内栓塞AN之后,每天或隔天行腰椎穿刺术并作CSF置换,另外44例为对照组行保守治疗。比较两组的病情转归及与Hunt和Hess分级相关性,比较两组治疗前与治疗后21天、90天、1年的Barthel指数(BI),并记录两组的不良事件。结果介入栓塞治疗组治疗后的病情转归明显优于对照组;治疗后21天、90天及1年的BI均较治疗前有明显改善;两组治疗后BI比较有统计学差异(均p<0·05)。Hunt和Hess分级越低,治疗效果及预后越好。介入栓塞治疗组不良事件发生率远低于对照组(p<0·05)。结论SAH患者保守治疗效果极差,在介入栓塞AN后持续行CSF置换,能安全、有效地改善SAH的预后。
Objective To evaluate the effect, security and prognosis of replacement of cerebrospinal fluid to treat subarachnoid hemorrhage patients after the embolization of cerebral aneurysm. Methods 136 patients with sub- arachnoid hemorrhage were divided into two groups. The embolism group had 92 patients which were treated with replacement of cerebrospinal fluid after the embohzation of intracranial aneurysm. And the control group had 44 cases which were treated with routine therapy. The effect and side - effect were observed and compared between the two groups. Results The prognosis of the embolism group was better than the control group （p 〈 0. 05 ） ; In the embehsm group the BI of 21d,90d and 1 year were increased conspicuously than before treatment （p＇〈 0. 05 ）. The lower the Hunt Hess grade was, the better the effect and prognosis would be. The harmful event of the embolism was much lower than the control group （p 〈 O. 05 ）. Conclusion The effect of conservative treatment of subarachnoid hemorrhage was very pool, the treatment of replacement of cerebrospinal fluid after the embolization could improve the prognosis effectively and securely.
出处
《现代医院》
2010年第4期53-56,共4页
Modern Hospitals
关键词
蛛网膜下腔出血
颅内动脉瘤
介入栓塞
脑脊液置换
预后
Subaraehnoid hemorrhage, Intracranial aneurysm, Embolization, Replacement of cerebrospinal fluid, Prognosis
