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腰大池置管联合侧脑室引流治疗对脑室出血患者 脑 CT 灌注成像参数的影响
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R743.34

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Effect of lumbar cistern catheterization combined with lateral ventricle drainage on cerebral CT perfusion imaging parameters in patients with ventricular hemorrhage
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    摘要:

    目的 分析腰大池置管联合侧脑室引流治疗脑室出血患者对脑 CT 灌注成像参数(对比剂平均通过时间、对比剂达峰时间、 脑血流量、脑血容量)水平的影响,以期为治疗脑室出血提供理论依据。方法 选择乌鲁木齐市友谊医院 2020 年 5 月至 2022 年 5 月收 治的脑室出血患者 100 例,采用随机数字表法分为对照组(50 例,传统侧脑室引流术治疗)和试验组(50 例,腰大池置管联合侧脑室引 流治疗),两组患者均于术后随访 6 个月。比较两组患者治疗后的临床疗效、引流总时间、脑室积血消失时间、脑脊液转清时间,术后 3、7、14 d 对比剂平均通过时间、对比剂达峰时间、脑血流量、脑血容量水平,术前与术后 6 个月简明健康状况量表(SF-36)评分,以 及术后 6 个月格拉斯哥预后评分(GOS)。结果 试验组患者治疗后临床总有效率为 96.00%,较对照组的 82.00% 显著升高;与对照组 比,试验组患者引流总时间、脑室积血消失时间、脑脊液转清时间均显著缩短;与术后 3 d 比,术后 7、14 d 两组患者对比剂平均通过时 间、对比剂达峰时间呈先延长后缩短趋势,且试验组较对照组显著缩短;脑血流量、脑血容量呈先降低后升高趋势,且试验组较对照组 显著升高;与术前比,术后 6 个月两组患者社会功能、精神健康、情感职能、生理功能评分均显著升高,且试验组较对照组显著升高; 术后 6 个月试验组恢复良好(GOS 评分为 5 分)患者占比较对照组显著升高(均P<0.05)。结论 腰大池置管联合侧脑室引流治疗可缩 短脑室出血患者引流与脑室出血时间,改善脑血流灌注,促进预后恢复,并提高生活质量,效果显著。

    Abstract:

    Objective To analyze the effects of lumbar cistern catheterization combined with lateral ventricle drainage on the cerebral CT perfusion imaging parameters (mean transit time, time to peak contrast agent, cerebral blood flow, cerebral blood volume) in patients with ventricular hemorrhage, so as to provide reference for clinical treatment. Methods A total of 100 patients with intraventricular hemorrhage admitted to Urumqi Friendship Hospital from May 2020 to May 2022 were selected and divided into control group (50 cases, treated with traditional lateral ventricle drainage) and the experimental group (50 cases, treated with lumbar cistern catheterization combined with lateral ventricle drainage) according to the random number table method, both groups were followed up for 6 months after operation. The clinical curative effect, the total drainage time, ventricular hemorrhage disappear time, the clearing time of cerebrospinal fluid, mean transit time, time to peak contrast agent, cerebral blood flow, cerebral blood volume on the 3, 7, 14 days after operation, 36-item short form survey (SF-36) score before operation and 6 months after operation, and glasgow outcome scale (GOS) score 6 months after operation were compared between the two groups. Results The total clinical effective rate of patients in the experimental group after treatment was 96.00%, which was significantly higher than 82.00% in the control group; the total drainage time, ventricular hemorrhage disappear time, and the clearing time of cerebrospinal fluid in the experimental group were significantly shorter than those in the control group; compared with 3 days after operation, the mean transit time, time to peak contrast agent of patients in the two groups at 7 and 14 days after operation showed a trend of prolonging and then shortening, the experimental group was significantly shorter than the control group; cerebral blood flow, cerebral blood volume in the two groups decreased and then increased, the experimental group was significantly higher than the control group; compared with before operation, the scores of social function, mental health, emotional function and physiological function of patients in the two groups significantly increased at 6months after operation, the experimental group was significantly higher than the control group; the proportion of patients who recovered well (GOS score was 5 ) in the experimental group at 6 months after operation was significantly higher than that in the control group (all P<0.05). Conclusion Lumbar cistern catheterization combined with lateral ventricular drainage can shorten the drainage and ventricular hemorrhage time in patients with ventricular hemorrhage, promote prognosis recovery, improve the quality of life, with remarkable effect.

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  • 在线发布日期: 2023-02-24
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