改良隧道式腰大池引流对动脉瘤性蛛网膜下腔出血患者导管相关并发症的影响

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关键词：动脉瘤性蛛网膜下腔出血；改良隧道式腰大池置管引流；并发症；传统术式；脑脊液引流 中图分类号：R743.35文献标志码：A文章编号：1001-5779（2025）08-0756-04 DOI：10.3969/j. issn. 1001-5779.2025.08.005

Abstract：Objective：Toevaluatethepostoperativecomplicationsofmodifiedtunnellumbarcisterndrainageforaneurysmal subarachnoid hemorrhage（aSAH）.Methods：Aretrospectiveanalysis wasconductedonthedataof86aSAHpatients admited fromOctober 2O21 toDecember 2024.According tothecerebrospinal fluid drainage method，the patients were divdedinto traditional groupandimproved groups，with43casesineachgroup.Inthetraditionalgroup，L3/4orL4/5 lumbar puncture wasperformedaccording to thestandard procedure，and thecatheter wasplaced subdural about10-15cm， fixedwithadressng，andconnected toacloseddrainage system.Thedrainage heightwas maintainedat15-2Ocmabove theexternal auditorycanalline.Inthe modified group，aftersuccessulcatheterizationas inthe traditional group，a 0.5 cm incision was made at the puncture site，and a subcutaneous tunnel >5 cm was established using a puncture needle. The catheter was placed inthesubcutaneous tunnelandanother incision was made to lead itout.The tunnel exit was fixed with a cross suture.The postoperative complications wereobserved in two groups of patients，including intracranial infection，catheter displacement，cerebrospinal fluid leakage，catheter blockage，andunplanned catheterremoval.Results：Theincidenceofintracranialinfection，catheterdisplacement，andunplannedcatheterremovalinhemodified group was lower than those in the traditional group，with statistically significant difference（ P<0.05 ）.There was no statisticallysignificant diference in cerebrospinal fluid leakageand catheter blockage between the two groups （ P>0.05 ）Conclusion：The modified tunneled lumbar cistern drainage techniquecan efectivelyreducetheincidenceof intracranial infection，catheter displacement，and unplanned catheter removal in aSAH patients.

Key words ：Aneurysmal subarachnoid hemorrhage（aSAH）；Modified tunneled lumbar cisternal catheter drainage Complications；Conventional technique；Cerebrospinal fluid（CSF） drainage

动脉瘤性蛛网膜下腔出血（Aneurysmalsub-arachnoidhemorrhage，aSAH）属于严重的神经系统急症，具有高致死率和高致残率[1-3]，其治疗的关键在于病因治疗及合理的围手术期管理。（剩余6016字）