脑脊液置换治疗颅内动脉瘤填塞术后脑血管痉挛

Cerebrospinal fluid replacement in cerebrovascular spasm after intracranial aneurysm packing

目的探讨脑脊液置换治疗蛛网膜下腔出血(SAH)颅内动脉瘤填塞术后继发脑血管痉挛(CVS)的临床疗效。方法 60例SAH颅内动脉瘤填塞术后并发CVS患者随机分成治疗组与对照组各30例,2组均给予常规治疗,治疗组在此基础上早期予脑脊液置换疗法。结果 2组头痛缓解、颈项强直及血性脑脊液恢复正常的时间、脑血管痉挛发生率及病死率比较均有显著性差异。结论早期予脑脊液置换术可减少脑血管痉挛发生率,降低致残率及病死率,治疗SAH简单、安全、有效。

Objective It is to approach the clinical effect of cerebrospinal fluid replacement on cerebrovascular spasm（CVS） after intracranial aneurysm packing in patients with subarachnoid hemorrhage（SAH）.Methods Sixty confirmed CVS after intracranial aneurysm packing in patients with SAH were randomly divided into two groups with 30 cases in each group,all patients were received the conventional treatment,and the treatment group plus cerebrospinal fluid replacement.Results There were obvious differences between the two groups in headaches relief,neck rigidity,and the recovery time of bloody cerebrospinal fluid,the CVS incidence and the death rate.Conclusion Cerebrospinal fluid replacement in the early stage can reduce CVS incidence,disability rate and death rate.It is an effective,safe and simple way to treat for SAH.