【摘要】 目的分析终板造瘘治疗动脉瘤性蛛网膜下腔出血导致慢性脑积水的疗效。方法回顾性分析我院神经外科2015年1月至2017年12月期间收治的165例行开颅动脉瘤夹闭术患者资料。根据是否行终板造瘘分为终板造瘘组(72例)和非终板造瘘组(93例)。终板造瘘组符合Fisher分级:Ⅰ级(9例)、Ⅱ级(12例)、Ⅲ级(31例)、Ⅳ级(20例);非终板造瘘组符合Fisher分级:Ⅰ级(13例)、Ⅱ级(21例)、Ⅲ级(40例)、Ⅳ级(19例)。术后随访6个月。通过对比两组慢性脑积水的发生率的统计学差异。结果非终板造瘘组Fisher分级Ⅰ～Ⅱ级慢性脑积水发生率(11.76%)和终板造瘘组Fisher分级Ⅰ-Ⅱ级慢性脑积水发生率(4.76%)比较,无统计学差异(χ2=0.770,P=0.380);非终板造瘘组FisherⅢ级慢性脑积水的发生率(30%)高于终板造瘘组FisherⅢ级的慢性脑积水发生率(9.68%)(χ2=4.329、P=0.037);非终板造瘘组FisherⅣ级慢性脑积水的发生率(36.84%)高于终板造瘘组FisherⅣ级的慢性脑积水发生率(10%)(χ2=3.955,P=0.047)。结论终板造瘘可以降低动脉瘤性蛛网膜下腔出血后FisherⅢ-Ⅳ级患者慢性脑积水的发生率。更多还原

【Abstract】 Objective To analyze the effect of fenestration of the lamina terminalis(FLT)in the treatment of chronic hydrocephalus caused by aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 165 patients with aneurysm were included in the study.The patients underwent elective craniotomy and aneurysm clipping in Neurosurgery Dept.of our hospital from January 2015 to December2017.According to whether or not FLT was performed during surgery,the patients were divided into FLT group(n=72)and non-FLT group(n=93).FLT group was composed of included gradeⅠ(9 cases),gradeⅡ(12 cases),grade Ⅲ(31 cases),and grade IV(20 cases)in terms of the Fisher classification.non-FLT group includedⅠgrade(n=13),Ⅱgrade(n=21),Ⅲgrade(n=40),Ⅳgrade(n=19).All patients were followed up for 6 months.The incidence of chronic hydrocephalus between the two groups were compared.Results In the patients with FisherⅠand Ⅱ grade,incidence of chronic hydrocephalus were no statistically significant differences between FLT group and non-FLT group(χ2=0.770,P=0.380).In the patients with Fisher Ⅲ grade,incidence of chronic hydrocephalus were statistically higher in nonFLT group than in FLT group(χ2=4.329,P=0.037).In the patients with Fisher Ⅳ grade,incidence of chronic hydrocephalus were statistically higher in non-FLT than in FLT group(χ2=3.955,P=0.047).Conclusion In aSAH patients with Fisher Ⅲ and Ⅳ grade,FLT can reduce the incidence of chronic hydrocephalus.更多还原