【摘要】 目的:探讨终板造瘘对动脉瘤性蛛网膜下腔出血后慢性脑积水的影响。方法:回顾性分析201例动脉瘤性蛛网膜下腔出血患者的临床资料,将所有患者按动脉瘤夹闭术中是否进行终板造瘘分为两组,随访6个月以上,评价其慢性脑积水的发生率。结果:所有患者慢性脑积水的总发生率为17.4%,终板造瘘组慢性脑积水的发生率7.8%,而单独夹闭组慢性脑积水的发生率为28.1%,显著高于终板造瘘组(P<0.05)。在FisherⅠ-Ⅱ级中,终板造瘘组与单独夹闭组慢性脑积水的发生率分别为5.0%、7.7%,两组比较无统计学差异(P>0.05);FisherⅢ-Ⅳ级中,终板造瘘组与单独夹闭组慢性脑积水的发生率分别为10.8%、40.3%,单独夹闭组显著高于终板造瘘组(P<0.05);而Hunt-HessⅠ-Ⅱ级中,终板造瘘组与单独夹闭组慢性脑积水的发生率分别为7.0%、9.4%,两组比较无统计学差异(P>0.05),Hunt-HessⅢ-Ⅳ级中终板造瘘与单独夹闭组慢性脑积水的发生率分别为11.3%、46.5%,单独夹闭组显著高于终板造瘘组(P<0.05)。结论:终板造瘘可明显降低Hunt-HessⅢ-Ⅳ级、FisherⅢ、Ⅳ级动脉瘤性蛛网膜下腔出血后患者慢性脑积水的发生率,而对Hunt-HessⅠ-Ⅱ级、FisherⅠ-Ⅱ级的动脉瘤性蛛网膜下腔出血后患者慢性脑积水的发生率影响不明显。更多还原

【Abstract】 Objective: To explore the influence of fenestration of the lamina terminalis(FLT) on chronic hydrocephalus after aneurysmal subarachnoid hemorrhage(a SAH). Methods: The clinical data of 201 cases of a SAH patients were retrospectively analyzed,who were divided into 2 groups by whether FLT had been performed or not. The patients were followed up more than 6 months and the incidence of the chronic hydrocephalus was evaluated. Results: The overall incidence of chronic hydrocephalus was 17.4%. The incidences of chronic hydrocephalus were retrospectively 7.8% and 28.1% in the FLT group and non-FLT group, which was significantly lower in the FLT group(P<0.05). In the patients with FisherⅠ-Ⅱ grade, no significant difference was found in the incidences of chronic hydrocephalus between FLT group and non-FLT group(5.0% vs 7.7%, P>0.05); in the patients with Fisher Ⅲ-Ⅳ grade, the incidences of chronic hydrocephalus were retrospectively 10.8% and 40.3% in FLT group and non-FLT group, which was significantly lower in the FLT group(P<0.05). But in the patients with Hunt-HessⅠ-Ⅱ grade, the incidences of chronic hydrocephalus were retrospectively 7.0% and 9.4%, no significant difference was found between the two groups(P>0.05); while in the patients with Hunt-Hess Ⅲ-Ⅳgrade, the incidences of chronic hydrocephalus were retrospectively 11.3% and 46.5%, which was significantly lower in the FLT group(P<0.05).Conclusion: FLT could remarkably reduce the incidence of the chronic hydrocephalus in the cases of a SAH patients with Fisher Ⅲ-Ⅳand Hunt-Hess Ⅲ-Ⅳ grade, but 1 had little effect on the cases of a SAH patients with Fisher Ⅰ-Ⅱ and Hunt-Hess Ⅰ-Ⅱs grade.更多还原