【作者】 尹浩； 马骏； 刘窗溪； 谌鸿斌； 韩国强； 高方友； 王俊； 熊云彪； 王超； 杨恒；

【Author】 YIN Hao;MA Jun;LIU Chuang-Xi;Department of neurosurgery, Guizhou Provincial People’s Hospital;

【机构】 贵州省人民医院神经外科；

【摘要】 目的:探讨和评价终板造瘘联合持续腰大池置管引流前循环动脉瘤破裂后急性脑积水的疗效。方法:回顾性分析2009年1月至2012年6月间,收治的前循环动脉瘤破裂蛛网膜下腔出血后导致急性脑积水患者共126例。予动脉瘤夹闭术中行终板造瘘术,联合术中或术后腰穿腰大池置管持续外引流治疗共66例(治疗组)。同期开颅夹闭的患者60例(对照组)。随访平均16.3±8.2月。结果:引流日数为13.6±7.5天,治疗组共2例发生慢性脑积水,发生率为3.8%。对照组共10例发生慢性脑积水,发生率为16.7%。两组有显著性差异(p<0.05)。12例最终均行脑室-腹腔分流治愈。治疗组无视力下降病例。结论:终板造瘘联合持续腰大池置管引流,可预防前循环动脉瘤破裂后急性脑积水的发生。更多还原

【Abstract】 Objective:To investigate and evaluate efficacy of treatment of fenestration of the lamina terminalis with continuous lumbar cistern drainage for acute hydrocephalus after subarachnoid hemorrghage of anterior-circulation aneurysm.Methods:From Jan.2008 to Mar.2012,126 patients suffering acute hydrocephalus after anterior circulation aneurysm rupture were retrospectively reviewed.66 patients(Treatment Group,TG) underwent fenestration of the lamina terminalis in the operation and intraoperative lumbar-puncture CSF drainage.60 patients(Control Group,CG)underwent regular neurosurgical clipping procedure.Follow-up time was 16.3 +8.2months.Results:The period of drainage was 13.6 + 7.5 days.There were 2 patients in TG and 10 patients in CG suffering chronic hydrocephalus(3.8%and 16.7%).There was a significant difference between two groups.All patients eventually cured by the ventriculo-peritoneal shunt.Impaired vision was not found in TG.Conclusion:The fenestration of the lamina terminalis associated with CSF drainage by lumbar puncture should be recommended to manage the patients who suffer acute hydrocephalus after subarachnoid hemorrhage of anterior circulation aneurysm.更多还原