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外腔室排水与腰部排水在动脉瘤下arachnoid出血的有效性:一个倾向匹配的多中心研究

Xiuhu An¹, Bangyue Wang², Xinbo Ge³

¹Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.

International journal of stroke : official journal of the International Stroke Society

|May 12, 2025

概括

腰部排水 (LD) 与外腔室排水 (EVD) 相比,在动脉瘤下arachnoid出血 (aSAH) 中显示出更好的短期功能结果和长期存活率. 两种方法都没有在长期功能或并发症方面有所不同.

科学领域:

神经外科神经外科
关键护理医学关键护理医学
神经学神经学

背景情况:

对动脉瘤下关节出血 (aSAH) 的最佳脑脊液 (CSF) 排水策略仍在争论中.
外腔室排水 (EVD) 和腰部排水 (LD) 是常见的CSF管理技术.

研究的目的:

在aSAH患者中比较EVD与LD的疗效和安全性.
确定影响CSF排水战略结果的因素.

主要方法:

334名aSAH患者 (167名EVD,167名LD) 的倾向性得分匹配 (PSM) 来自中国多中心脑动脉瘤数据库 (CMAD).
两年死亡率,功能结果和住院并发症的比较.
使用通用估计方程 (GEE) 和考克斯比例危险建模.

主要成果:

埃博拉病毒感染组的两年死亡率较高 (27.1%对15.1%),排放功能结果较差 (45.5%对34.0%).
两年功能结果没有显著差异 (23.4%对22.0%).
住院并发症率相似;WFNS等级IV-V,年龄≥65,糖尿病是死亡风险因素.

结论:

腰部排水 (LD) 在aSAH管理中提供优越的短期功能和长期生存益处.
在长期功能结果或并发症率方面没有发现显著差异.
识别的预后因素可以指导CSF排水的临床决策.

关键词:

动脉瘤下arachnoid出血动脉瘤下arachnoid出血动脉瘤下arachnoid出血动脉瘤下arachnoid出血并发症可能导致并发症.外腔室排水系统的外腔室排水系统腰部排水系统腰部排水系统死亡率死亡率结果结果结果结果.

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