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| Clinical Effect of Lumbar Cistern Drainage Combined with 3H therapy in the Subarachnoid Hemorrhage after Aneurysm Clipping Operation and its Effect on Vasoactive Factors |
| CHEN Shao-hua |
| Neurology,Leshan geriatric hospital,Leshan, Sichuan,614000 |
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Abstract 【Objective】 To study the clinical effect of lumbar cistern drainage combined with hypertension, high blood volume and hemodilution (3H) on subarachnoid hemorrhage after aneurysm clipping operation and its effect on vasoactive factors. 【Methods】 From May 2016 to May 2017, 116 patients with subarachnoid hemorrhage were randomly divided into two groups: the control group (n = 58) and the observation group (n=58). The control group was treated with lumbar cistern drainage after aneurysm clipping. The observation group combined with 3 H therapy on the basis of the control group. The therapeutic effects, postoperative complications, serum C-reactive protein (CRP) and S100 levels, plasma diastolic factor (NO), contraction factor (ET-1), thromboxane B2 (TXB2) and human 6-keto-prostacyclin (6-K-PGF1α) levels were compared between the two groups.【Results】 The effective rate of treatment in the observation group was 93.1%, which was significantly higher than that in the control group 70.4%(P<0.05); the headache score and cerebral vasospasm in the observation group were significantly lower than those in the control group (P<0.05), and the craniocerebral hydrocephalus and mortality were significantly lower than those in the control group (P<0.05). Before intervention, there was no significant difference in serum CRP,S100 level and plasma NO,ET-1,TXB2 and 6-K-PGF1α levels between the two groups (P>0.05), and after intervention, the indexes in the observation group were significantly lower than those in the control group (P<0.05).【Conclusion】 The treatment of subarachnoid hemorrhage by lumbar cistern drainage combined with 3H after aneurysm clipping is safe and reliable. It can reduce complications and ensure survival rate.
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Received: 09 March 2018
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[1] 侯青,王洪生,张海霞,等.动脉瘤夹闭术后行尼莫地平联合腰大池引流术对患者脑血管痉挛及脑氧供需平衡的影响[J].山西医药杂志,2017,46(7):786-788.
[2] Kawasaki T, Fukuda H, Kurosaki Y,et al. Acute compressive myelopathy caused by spinal subarachnoid hemorrhage: a combined effect of asymptomatic cervical spondylosis[J].World Neurosurg,2016,95:619.
[3] 张慧,步星耀,杨冬谊,等.神经生长因子经鼻脑靶向联合腰大池外引流治疗外伤性蛛网膜下腔出血临床观察[J].中华实用诊断与治疗杂志,2015,29(12):1234-1236.
[4] 赵元元,徐建林,楼林.前列地尔联合尼莫地平预防动脉瘤性蛛网膜下腔出血后症状性脑血管痉挛的疗效[J].中国临床药学杂志,2015,6(1):4-8.
[5] 杜昌旺,史罗宁,宋锦宁,等.外侧裂池置管注射硝普钠对动脉瘤性蛛网膜下腔出血术后并发症及预后的影响[J].陕西医学杂志,2016,45(6):695-696.
[6] Karic T, R e C, Nordenmark T H, et al. Effect of early mobilization and rehabilitation on complications in aneurysmal subarachnoid hemorrhage[J].J Neurosurg,2017,126(2):518-526.
[7] 李立,周峰,赵学群,等.腰大池置管术在动脉瘤性蛛网膜下腔出血后血管痉挛中的作用[J].中华急诊医学杂志,2015,24(12):1357-1363.
[8] 贾云飞.中西医结合治疗创伤性蛛网膜下腔出血疗效观察[J].现代中西医结合杂志,2015,24(4):406-408.
[9] 李金燕,蔡文芳,尹萍,等.音乐联合抚触唤醒对动脉瘤性蛛网膜下腔出血后脑性昏迷的意识状态及神经功能的影响[J].中国临床研究,2016,34(9):1278-1281.
[10] Kumar G, Shahripour RB, Harrigan MR. Vasospasm on transcranial Doppler is predictive of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis[J].J Neurosurg,2016,124(5):1257-1264.
[11] 张玲,莫晔,李应宏,等.早期腰大池引流与腰椎穿刺脑脊液置换对蛛网膜下腔出血患者血管痉挛的影响[J].海南医学,2016,27(14):2289-2291.
[12] 陈军辉,王玉海,杨理坤,等.超早期手术夹闭治疗高分级动脉瘤性蛛网膜下腔出血[J].国际脑血管病杂志,2015,23(11):830-835.
[13] Abolfazli E, Fatouraee N, Seddighi AS.Effects of lumbar drainage on CSF dynamics in subarachnoid hemorrhage condition: a computational study[J].Comput Biol Med,2016,77:49-58.
[14] 刘炎,杭春华,茅磊,等.高分级动脉瘤性蛛网膜下腔出血颅内动脉瘤夹闭术后不同引流方式的疗效及对预后的影响[J].疑难病杂志,2017,16(6):908-909. |
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2018, Vol. 35 
