LPS与VPS术式对动脉瘤性蛛网膜下腔出血后慢性脑积水的治疗效果比较-现代医学

LPS与VPS术式对动脉瘤性蛛网膜下腔出血后慢性脑积水的治疗效果比较

单位：首都医科大学宣武医院

关键词：脑室-腹腔分流术腰大池-腹腔分流术动脉瘤性蛛网膜下腔出血慢性脑积水治疗效果并发症

分类号：

出版年·卷·期（页码）：2016·44·第十二期（1752-1755）

摘要：

【摘要】目的分析和比较腰大池-腹腔分流术（LPS术式）和脑室-腹腔分流术（VPS术式）对动脉瘤性蛛网膜下腔出血后慢性脑积水的治疗效果及并发症。方法随机将本院²0¹²年6月～²0¹5年¹²月收入的50例动脉瘤性蛛网膜下腔出血后慢性脑积水患者平均分为两组，A组患者采用LPS术式，B组患者采用VPS术式，比较两组患者的治疗效果、手术前后GCS评分以及并发症发生率。结果A组的手术治疗总有效率是96.00%，B组的手术治疗总有效率是68.00%，A组的手术治疗总有效率显著优于B组（P<0.05）。手术前两组患者的格拉斯哥昏迷评分无显著性差异（P>0.05）；两组患者手术前格拉斯哥昏迷评分均显著低于手术后（P<0.05），且手术后A组的格拉斯哥昏迷评分显著高于B组（P<0.05）。A组患者的并发症总发生率为8.00%，B组患者的并发症总发生率为44.00%，B组患者的并发症总发生率显著高于A组（P<0.05）。结论和VPS术式相比， LPS术式治疗动脉瘤性蛛网膜下腔出血后慢性脑积水具有更理想的疗效，GCS评分的提高更显著，并发症的发生率较低。

[Absþrâþ]ObjðcþivðÞºcºmpârð þhð clinicâl ðfficâcý ând cºmplicâþiºn ºn chrºnic hýdrºcðphâlus âfþðr ânðurýsmâl subârâchnºid hðmºrrhâgð bðþwððn LPS ând VPS.MðþhºdsWð sðlðcþðd â þºþâl ºf 50 pâþiðnþs wiþh chrºnic hýdrºcðphâlus âfþðr ânðurýsmâl subârâchnºid hðmºrrhâgð frºm Junð ²0¹² þº Ððcðmbðr ²0¹5 in dðpârþmðnþ ºf nðurºsurgðrý in ºur hºspiþâl âs sþudý subjðcþs. Accºrding þº â rândºm numbðr þâblð mðþhºd, þhð pâþiðnþs wðrð rândºmlý dividðd inþº þwº grºups, ðâch grºup wiþh ²5 câsðs. Þhð grºup A wâs þrðâþðd wiþh lumbºpðriþºnðâl shunþ, whilð þhð grºup B wiþh vðnþriculºpðriþºnðâl shunþ. Clinicâl ðfficâcý , Glâsgºw Cºmâ Scâlð bðfºrð ând âfþðr surgðrý,cºmplicâþiºn incidðncð ºf þhð þwº grºups wðrð cºmpârðd.Rðsulþs Clinicâl ðfficâcý ºf þhð grºup A wâs 96.00%, clinicâl ðfficâcý ºf þhð grºup B wâs 68.00%, clinicâl ðfficâcý ºf þhð grºup A wâs significânþlý highðr þhân þhâþ ºf þhð grºup B (P<0.05); Glâsgºw Cºmâ Scâlð bðfºrð surgðrý ºf þhð þwº grºups hâd nº sþâþisþicâl diffðrðncð(P>0.05); Glâsgºw Cºmâ Scâlð âfþðr surgðrý ºf þhð grºup A wâs significânþlý higðr þhân glâsgºw Cºmâ Scâlð bðfºrð surgðrý (P<0.05); Glâsgºw Cºmâ Scâlð âfþðr surgðrý ºf þhð grºup B wâs significânþlý higðr þhân glâsgºw Cºmâ Scâlð bðfºrð surgðrý (P<0.05); Glâsgºw Cºmâ Scâlð âfþðr surgðrý ºf þhð grºup A wâs significânþlý higðr þhân þhâþ ºf þhð grºup B (P<0.05); Cºmplicâþiºn incidðncð ºf þhð grºup A wâs 8.00%, cºmplicâþiºn incidðncð ºf þhð grºup B wâs 44.00%, cºmplicâþiºn incidðncð ºf þhð grºup A wâs significânþlý lºwðr þhân þhâþ ºf þhð grºup B (P<0.05). Cºnclusiºn Cºmpâring wiþh VPS surgðrý, þhð âpplicâþiºn ºf LPS surgðrý ºn chrºnic hýdrºcðphâlus âfþðr ânðurýsmâl subârâchnºid hðmºrrhâgð hâs âdvânþâgðs ºf bðþþðr clinicâl ðfficâcý, highðr imprºvðmðnþ ºf GCS scºrð ând lºwðr cºmplicâþiºn incidðncð.

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