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【medical-news】动脉瘤性蛛血后脑积水的治疗不会
in Patients With Aneurysmal Subarachnoid Hemorrhage
Catharine A. Hellingman, MD; Walter M. van den Bergh, MD; Inge S. Beijer, MD;
Gert W. van Dijk, MD; Ale Algra, MD; Jan van Gijn, MD, FRCP(E); Gabrie¨l J.E. Rinkel, MD
Background and Purpose—Cerebrospinal fluid drainage is often indicated in patients with acute hydrocephalus after
aneurysmal subarachnoid hemorrhage but is believed to increase the risk of rebleeding. We studied the risk of rebleeding
in patients with subarachnoid hemorrhage during treatment for acute hydrocephalus.
Methods—We included patients with hydrocephalus treated with external ventricular drainage or lumbar punctures within
4 days after the hemorrhage and before aneurysm occlusion. Each treated patient was matched with a control patient
with untreated hydrocephalus and a control patient without ventricular enlargement. Patients and controls were matched
for interval since subarachnoid hemorrhage, duration of exposure, use of tranexamic acid, clinical condition on
admission, and age. We used Cox regression to calculate hazard ratios and we adjusted for rebleeding that had occurred
before starting the cerebrospinal fluid drainage.
Results—In the group treated with external ventricular drainage, rebleeding occurred in seven of 34 patients (21%) with
treatment, in seven of 34 controls (21%) with untreated hydrocephalus, and in six of 34 controls (18%) without
hydrocephalus. In the group treated with one or more lumbar punctures, rebleeding occurred in one of 21 patients (5%)
with treatment, in three of 21 controls (14%) with untreated hydrocephalus, and in none of the 21 controls without
hydrocephalus. The hazard ratios for rebleeding were 1.0 (95% CI: 0.4 to 2.7) for external ventricular drainage treatment
and 0.7 (95% CI: 0.1 to 6.4) for lumbar puncture treatment.
Conclusion—This study does not confirm an importantly increased risk of rebleeding during external ventricular drainage
or lumbar punctures for acute hydrocephalus after aneurysmal subarachnoid hemorrhage. (Stroke. 2007;38:96-99.) 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 请指正：
Risk of Rebleeding After Treatment of Acute Hydrocephalus
in Patients With Aneurysmal Subarachnoid Hemorrhage
动脉瘤性蛛网膜下腔出血并发脑积水的患者治疗后的再出血的危险性
Catharine A. Hellingman, MD; Walter M. van den Bergh, MD; Inge S. Beijer, MD;
Gert W. van Dijk, MD; Ale Algra, MD; Jan van Gijn, MD, FRCP(E); Gabrie¨l J.E. Rinkel, MD
Background and Purpose—Cerebrospinal fluid drainage is often indicated in patients with acute hydrocephalus after
aneurysmal subarachnoid hemorrhage but is believed to increase the risk of rebleeding.
背景和目的：
动脉瘤性蛛网膜下腔出血并发脑积水患者一般是脑脊液引流的指征；但是被认为有增加再出血的危险性。
We studied the risk of rebleeding in patients with subarachnoid hemorrhage during treatment for acute hydrocephalus.
我们研究了蛛网膜下腔出血并发急性脑积水患者的在治疗过程中再出血的危险性。
Methods—We included patients with hydrocephalus treated with external ventricular drainage or lumbar punctures with in 4 days after the hemorrhage and before aneurysm occlusion.
方法：我们选择出血在4天内和动脉瘤闭塞前并发脑积水的患者行脑室引流或者腰椎穿刺引流。
Each treated patient was matched with a control patient
with untreated hydrocephalus and a control patient without ventricular enlargement.
每个脑积水引流的患者都有一个对脑积水未进行处理和脑室未扩大的患者作为对照。
Patients and controls were matched for interval since subarachnoid hemorrhage, duration of exposure, use of tranexamic acid, clinical condition on admission, and age.
患者和对照组在蛛网膜下腔出血的时间、持续暴露的时间 、应用氨甲环酸、 入院条件和年龄等方面相匹配。
We used Cox regression to calculate hazard ratios and we adjusted for rebleeding that had occurred before starting the cerebrospinal fluid drainage.
我们应用回顾方法评估危害比 ，在行脑脊液引流前
我们对已经发生再出血患者作调整。
Results—In the group treated with external ventricular drainage, rebleeding occurred in seven of 34 patients (21%) with treatment, in seven of 34 controls (21%) with untreated hydrocephalus, and in six of 34 controls (18%) without
hydrocephalus.
在通过脑脊液引流治疗组的结果显示，经过治疗的34例脑积水患者7例出现了再出血（21％），在未行脑脊液引流治疗的34例脑积水患者对照组中7例出现了再出血（21％），还有34例未患脑积水的患者的对照组中6例出现了再出血（18％）。
In the group treated with one or more lumbar punctures, rebleeding occurred in one of 21 patients (5%)
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作者:admin@医学,生命科学 2011-06-21 17:13
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