不等量脑脊液置换治疗外伤性蛛网膜下腔出血40例临床观察

A study of treatment of 40 cases of subarachnoid hemorrhage by cerebrospinal fluid replacement

目的:探讨不等量脑脊液置换应用于中、重度蛛网膜下腔出血的疗效。方法:回顾分析4年来具有完整资料的40例外伤性蛛网膜下腔出血的患者。结果:与对照组相比,治疗组在治愈率、平均治愈时间、脑脊液分时段压力测定等指标均明显优于对照组(P<0.05),其再出血、脑血管痉挛、脑积水三大并发症的发病率均明显低于对照组(P<0.05)。结论:不等量脑脊液置换应用于中、重度蛛网膜下腔出血的治疗,可以显著降低颅内压,并可减轻颅椎管间脑脊液压力波动、防治脑疝形成。充分置换血性脑脊液可减少积血对软脑膜的刺激,防止血管痉挛。此方法简单、安全、高效。

Objective： To explore the therapeutic effects of cerebrospinal fluid replacement on moderate and severe subarachnoid hemorrhage. Methods：The complete data of 40 cases of subarachnoid hemorrhage was collected and analyzed retrospectively. Results： Compared with the control group treated with conventional therapeutic methods, the curative rate, average healing time, cerebrospinal fluid pressure - time measurement indicators were better in the treated group treated with conventional therapeutic methods and cerebrospinal fluid replacement（P〈0. 05）. The incidences of complicantions, such as rebleeding, cerebral vasospasm, hydrocephalus, were lower in the treated group than those in the control group（P〈0.05）. Conclusion：Cerebrospinal fluid replacement for treatment of moderate and severe subarachnoid hemorrhage can significantly reduce intracranial pressure, reduce inter - cranial spinal cerebrospinal fluid pressure fluctuations and prevent herniation. Full cerebrospinal fluid replacement can reduce irritation of blood to cerebral piamater and prevent vasospasm. This therapeutic method is simple, safe and efficient.