蛛网膜下腔出血后脑脊液引流与分流依赖性脑积水的关系

摘要

Objective To investigate the relationship between the cerebrospinal fluid drainage and shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage (aSAH). Methods Clinical data of 68 aSAH patients were analyzed retrospectively, who received cerebrospinal fluid drainage for hydrocephalus caused by aSAH. The patients were divided into permanent drainage group (n=22) and non-permanent drainage group (n=46) according to existence or absence of shunt-dependent hydrocephalus. The correlation between cerebrospinal fluid drainage and shunt-dependent hydrocephalus was analyzed statistically. Results There were significant differences in preoperative Hunt-Hess grade, modified Fisher grade, intracranial infection and mean time of cerebrospinal fluid drainage between the two groups (P<0.05). The daily average volume of cerebrospinal fluid drainage within 7 days and 14 days were higher in permanent drainage group than in non-permanent drainage group (P<0.001). Conclusions The daily volume of cerebrospinal fluid shunt is an influence factor for shunt-dependent hydrocephalus after aSAH. The patients with higher volume cerebrospinal fluid drainage may be more prone to shunt-dependent hydrocephalus.%目的 探讨动脉瘤性蛛网膜下腔出血(aSAH)后脑脊液引流与分流依赖性脑积水的关系.方法 回顾性分析68例aSAH病人的临床资料,因aSAH致脑积水接受脑脊液引流治疗,根据是否出现分流依赖性脑积水,将病人分为永久分流组(n=22)和非永久分流组(n=46).统计分析脑脊液引流与分流依赖性脑积水的相关性.结果 两组病人在术前Hunt-Hess分级、改良Fisher分级、颅内感染、脑脊液平均引流时间的差异具有统计学意义(P<0.05).永久分流组7 d内与14 d内的脑脊液每日平均引流量均明显高于非永久分流组,其具有显著统计学差异(P<0.001).结论 aSAH后脑脊液每日引流量可能成为分流依赖性脑积水的影响因素,每日平均引流量高的病人易发展为分流依赖性脑积水.