文章摘要
王智 任付宾 王来藏 王超 张伟光 李建华.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[J].,2014,14(35):6863-6866
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
Influence of Fenestration of the Lamina Terminalis on ChronicHydrocephalus after Aneurysmal Subarachnoid Hemorrhage
  
DOI:
中文关键词: 动脉瘤性蛛网 膜下腔出 血  慢性脑积水  终板造瘘
英文关键词: Aneurismal ubarachnoid hemorrhage  Chronic hydrocephalus  Fenestration of the lamina terminalis
基金项目:黑龙江省教育厅基金项目( 1 1551214)
作者单位
王智 任付宾 王来藏 王超 张伟光 李建华 哈尔滨医科大学附属第四医院微创神经外科 
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中文摘要:
      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 1 7.4%, 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。
英文摘要:
      Objective:To explore the influence of fenestration of the lamina terminalis (FLT) on chronic hydrocephalus after aneurysmal subarachnoid hemorrhage (aSAH).Methods:The clinical data of 201 cases of aSAH 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 1 7.4% . 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 -Ⅳ grade, 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 aSAH patients with Fisher Ⅲ -Ⅳ and Hunt-Hess Ⅲ -Ⅳ grade, but 1 had little effect on the cases of aSAH patients with Fisher Ⅰ -Ⅱ and Hunt-Hess Ⅰ -Ⅱ s grade.
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