摘要
目的通过对颅内动脉瘤性蛛网膜下腔出血(a SAH)行腰大池引流患者后期分流依赖性脑积水发生的影响因素分析,为进一步完善术后腰大池置管的规范化治疗提供参考。方法对2010年1月至2014年1月收治的104例颅内动脉瘤术后行腰大池引流的患者(Hunt-HessⅠ-Ⅲ级)临床及影响学资料进行回顾性分析,将入院临床及影像学评估,手术方式及术后置管等因素纳入研究。结果其中17例患者(16.3%)发生术后分流依赖性脑积水,单因素分析提示出血量Fisher分级,动脉瘤部位、脑室内有否出血的差异性对后期分流依赖性脑积水发生影响显著(P<0.05),进一步行logistic多因素回归分析结果显示出血量Fisher分级,脑室内有否出血是影响腰大池引流后分流依赖性脑积水发生的独立危险因素(P<0.05)。结论对于Hunt-HessⅠ-Ⅲ级患者,即使围手术期规范化置入腰大池引流,其高Fisher分级以及脑室内出血仍是a SAH后分流依赖性脑积水形成的危险因素。
The study aims to discuss the risk factors of lumbar drainage for shunt- dependent hydrocephalus secondary to aneurysmal subarachnoid hemorrhage （aSAH）. Methods The clinical and radiographic data of 104 post-operative patients （Hunt-Hess I - m grade） who was performed lumbar drainage from January 2010 to January 2014 were retrospectively analyzed. Logistic regression was used to analyze the risk factors including clinical and radiographic data and operation methods. Results Among 104 patients, 17 （16. 3%） underwent ventriculoperitoneal shunt to resolve shunt-dependent hydrocephalus eventually. Univariate analysis showed that Fisher grade, location of ruptured aneurysm and the presence of intraventrieular hemorrhage were significantly associated with shunt-dependent hydrocephalus （ P 〈 0. 05 ） , while further Logistic regression made it clear that, Fisher grade and the presence of intraventricular hemorrhage were independent risk factors for shunt-dependent hydrocephalus in patients treated with lumbar drainage （ P 〈 0.05 ）. Conclusion In this cohort of patients, although standardization for lumbar drainage application and persistent drainage were adopted perioperatively, high Fisher grade and intraventricular hemorrhage are the significant predictors for shunt-dependent hydrocephalus.
出处
《中华神经外科疾病研究杂志》
CAS
2015年第6期523-527,共5页
Chinese Journal of Neurosurgical Disease Research
基金
国家自然科学基金资助项目(81171130)
