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目的探讨患者发生动脉瘤性蛛网膜下腔出血行开颅动脉瘤夹闭过程中终板造瘘对慢性脑积水的发生率的影响。方法将符合筛选条件的患者分为单纯开颅动脉瘤夹闭组和开颅动脉瘤夹闭+终板造瘘组,随访两组患者6个月至1年,分析发病后2周至1年内的颅脑CT或MRI扫描结果,评估两组及Fisher分级中蛛网膜下腔出血后慢性脑积水的发生率。结果动脉瘤夹闭+终板造瘘组术后慢性脑积水发生率10%,单纯动脉瘤夹闭组术后慢性脑积水发生率为20%,两组比较,有统计学意义(P<0.05);FisherⅢ~Ⅳ在两组慢性脑积水发生率分别为5.3%与20%,两组比较有显著性差(P<0.05)。结论对于FisherⅢ~Ⅳ动脉瘤性蛛网膜下腔出血患者术中终板造瘘可降低慢性脑积水的发生率。
Objective To investigate the effect of endplate ostomy on the incidence of chronic hydrocephalus in patients with aneurysmal subarachnoid hemorrhage undergoing craniotomy aneurysm clipping. Methods The patients who met the screening criteria were divided into simple craniotomy aneurysm clipping group and craniotomy aneurysm clipping + endplate ostomy group. The patients in both groups were followed up for 6 months to 1 year. The patients were followed up for 2 weeks to 1 year Brain CT or MRI scans were performed to assess the incidence of chronic hydrocephalus after subarachnoid hemorrhage in both groups and in the Fisher classification. Results The incidence of chronic hydrocephalus was 10% in aneurysm clamp + endplate ostomy group, and 20% in simple aneurysm clamp group. The difference between the two groups was statistically significant (P <0.05). The incidences of Fisher Ⅲ ~ Ⅳ in both groups were 5.3% and 20%, respectively, with significant difference between the two groups (P <0.05). Conclusion Intraoperative endostomy can reduce the incidence of chronic hydrocephalus in patients with Fisher Ⅲ ~ Ⅳ aneurysm subarachnoid hemorrhage.