脑脊液置换及鞘内注射地塞米松治疗蛛网膜下腔出血35例

35 Cases of Subarachnoid Hemorrhage Treated by Neurolymph Replacement Combining Dexamethasone Intrathecal Injection

目的观察早期采取脑脊液置换术联合地塞米松鞘内注射治疗方法,对降低蛛网膜下腔出血病人脑血管痉挛及脑积水发生率、改善预后的临床效果。方法确诊蛛网膜下腔出血的病人67例,随机划分治疗组35例及对照组32例,治疗组在常规治疗基础上早期采取脑脊液置换术联合地塞米松鞘内注射治疗,对照组仅进行常规治疗,比较两组病人脑血管痉挛与脑积水发生率及病情转归。结果治疗组和对照组脑血管痉挛发生率分别为17.14%、34.38%(P<0.05);治疗组和对照组脑积水发生率分别为11.43%、28.13%(P<0.01);治疗组和对照组病情转归评分分别为3.04±1.12、2.06±1.18(P<0.05)。结论早期采取脑脊液置换术联合地塞米松鞘内注射治疗可降低脑血管痉挛及脑积水发生率,改善病人预后。

Objective To observe the clinical effects of decreasing incidence of cerebral angio spasm and hydrocephaly and im-proving prognosis on patients with subarachnoid hemorrhage by early treatment of neurolymph replacement combining dexamethasone intrathecal injection. Methods 67 patients diagnosed as subarachnoid hemorrhage were randomly divided into 2 groups including 35 cases of test group and 32 cases of control group. Test group were early treated by neurolymph replacement combining dexamethasone intrathecal injection on the basis of normal treatment. Control group were normally treated. Differences of incidence of cerebral angio spasm and hydrocephaly and prognosis between two groups were observed. Results Incidence of cerebral angio spasm were 17.14% and 34.38% in test group and control group respectively(P<0.05). Incidence of hydrocephaly were 11.43% and 28.13% in test group and control group respectively(P<0.01). Scores of prognosis were 3.04±1.12 and 2.06±1.18 in 2 groups (P<0.05). Conclusions Incidence of cerebral angio spasm and hydrocephaly can be decreased and prognosis can be improved on patients with subarachnoid hemorrhage by early treatment of neurolymph replacement combining dexamethasone intrathecal injection.