Effect of cerebrospinal fluid drainage after aneurysm clipping on hydrocephalus,cerebral vasospasm and serum IGF-1,sVCAM-1 / 中国基层医药

ABSTRACT

Objective To investigate the value of cerebrospinal fluid drainage after aneurysm clipping in patients with intracranial aneurysm complicated with subarachnoid hemorrhage .Methods 84 intracranial aneurysms patients with subarachnoid hemorrhage were selected ,and they were randomly divided into study group (n =42) and control group (n =42).The control group used simple suture after aneurysm clipping ,the study group was given lumbar cistern drainage by implementation of the dural suture tube after aneurysm clipping .Before and after hydro-cephalus and cerebral vasospasm ,treatment changes of serum insulin-like growth factor 1 (IGF-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) levels were compared between the two groups .Results The incidence rate of hydrocephalus of the study gruop was 4.8%,which was significantly lower than the 14.3% of the control group (χ2 =9.743,P <0.05).The incidence rate of cerebral vasospasm of the study group was 7.1%,which was significantly lower than 19.0% of the control group (χ2 =11.802,P <0.05).The incidence rates of intracranial infection,cerebrospinal fluid leakage and other complications between the two groups had no statistically significant differences (χ2 =2.074,2.125,all P >0.05).The serum levels of IGF-1 and sVCAM-1 between the two groups had no statistically significant differences before operation (t =0.417,0.603,all P >0.05).At the 8th day after oper-ation,the serum levels of sVCAM-1 and IGF-1 of the study group were significantly lower than those of the control group (t =7.335,6.856,all P <0.05).Conclusion After aneurysm clipping,the lumbar cistern drainage tube drainage is beneficial to reduce hydrocephalus and cerebral vasospasm incidence ,inhibit the expression of serum IGF-1,sVCAM-1,with less adverse reactions,it is worthy of application.