早期腰大池持续引流治疗外伤性蛛网膜下腔出血

Treatment of Traumatic Subarachnoid Hemorrhage by Early Continuous Lumbar Cisterna Drainage

目的探讨早期腰大池脑脊液持续外引流对外伤性蛛网膜下腔出血的治疗效果。方法本组患者l14例,随机分为2组,治疗组69例,早期行腰大池脑脊液持续外引流;对照组45例,采用每天腰穿术放脑脊液。通过比较2组脑血管痉挛及脑积水的发生率评定疗效。结果脑血管痉挛发生率及慢性脑积水发生率治疗组分别为27.5%和10.1%,均明显低于对照组的68.8%和26.6%,2组急性脑积水分别为7.2%和11.1%,无明显差异。结论早期腰大池持续外引流能够有效地降低蛛网膜下腔出血后脑血管痉挛、慢性脑积水等严重并发症的发生率,是外伤性蛛网膜下腔出血有效的治疗措施。

Objective To study the effect of early continuous lumbar cisterna drainage on treating traumatic subarachnoid hemorrhage （TSAH）. Methods One hundred and fourteen cases with TSAH were divided into 2 groups randomly. Sixty-nine cases in the treatment group were treated with early continuous lumbar cisterna drainage and forty-five cases in the control group were treated with lumbar puncture daily. The incidences of cerebrovaseular spasm（CVS） and hydrocephalus in the two groups were compared to determine the efficacy, Results The incidences of CVS and chronic hydrocephalus in treatment group were 27.5% and 10.1% ,which were significantly lower than those in control group（68.8% and 26.6% ）. There was no obvious difference of the incidence of acute hydrocephalus between the two groups, which was 7.2% and 11.1% respectively. Conclusions The early continuous lumbar cisterna drainage can decrease the incidence of the post-operative CVS and chronic hydrocephalus complications of an traumatic subarachnoid hemorrhage, so it is an effective treatment for traumatic suharachnoid hemorrhage.