腰池脑脊液闭式引流与置换治疗重度蛛网膜下腔出血

Closed Drainage and Displacement of Cerebrospinal Fluid through Terminal Cistern for Treating Serious Subarachnoid Hemorrhage

目的评价腰池置管脑脊液闭式引流与置换技术治疗蛛网膜下腔出血(SAH)的临床价值,规范其操作方法。方法采用腰池置管脑脊液闭式引流与置换技术治疗外伤性、原发性或继发性SAH患者38例,常规内科治疗的38例SAH患者作为对照。结果治疗组患者头痛和颈项强直持续时间、昏迷时间较对照组明显缩短(P<0.05),且死亡率亦明显低于对照组(P<0.05)。无脑疝、脑积水、迟发性颅内血肿等并发症。结论腰池置管脑脊液闭式引流与置换技术简单实用、安全,疗效好,有临床推广价值。

Objective To explore the clinical application of closed drainage and displacement of cerebrospinal fluid （CSF） through terminal cistern to treating serious subarachnoid hemorrhage （SAH）. Methods Thirty-eight patients with traumatic and primary or secondary SAH were treated by closed drainage and displacement of CSF through the terminal cistern. Thirty-eight patients with SAH who were conservatively treated served as the control. Results The time of headache, neck rigidity and coma was the significantly shorter in the patients in the treatment group than that in the control group （P〈0.05）. The mortality was significantly lower in the treatment group （10.5%, 4/38） than that （21.1%, 8/38） in the control group （P〈0.05）. No complications such as cerebral herniation, hydrocephalus and delayed intracerebral hematoma occurred in the treatment group. Conclusion The closed drainage and displacement of CSF through terminal cistern are the simple, safe and effective methods to treat SAH.