腰椎蛛网膜下腔持续引流治疗蛛网膜下腔出血

Effect of Controlled Lumbar Cerebrospinal Fluid Drainage on Subarachnoid Hemorrhage

目的探讨改良式腰椎蛛网膜下腔持续引流术治疗蛛网膜下腔出血的疗效。方法将蛛网膜下腔出血患者65例根据治疗方法的不同分为实验组32例和对照组33例,实验组行改良式腰椎蛛网膜下腔持续引流术并鞘内注药治疗,对照组行传统间断腰椎穿刺术并鞘内注药治疗,并对其疗效进行分析。结果实验组优良率68.75%,对照组39.39%,实验组明显高于对照组,实验组与对照组比较差异有统计学意义(P<0.05),而病死率实验组12.05%,对照组27.27%,实验组低于对照组,但实验组与对照组比较差异没有统计学意义(P>0.05)。治疗组颅内压控制平稳,脑膜刺激减轻,减少了并发症和后遗症,效果较好,治疗组明显优于对照组(P<0.05)。结论改良式腰椎蛛网膜下腔持续引流术治疗蛛网膜下腔出血疗效令人满意。

Objective To explore the effects of continuous controlled lumbar cerebrospinal fluid drainage on subaraehnoid hemorrhage. Methods Sixty five patients with subarachnoid hemorrhage were divided into two groups basing on the different treatment measure from Aug. 2005 to Dec. 2009. The patients in the experiment group（n =32） were treated by continuous controlled lumbar cerebrospinal fluid drainage combined with intrathecal administration; while the patients in the contrast group （n = 33 ） were treated by traditional lumbar centesis combined with inner theca transfusion. The outcomes of the treatment were analyzed and compared between the two groups. Results The excellent and good rate was 68.75% in the treated group,and obviously higher than that （ 39.39% ） in the contrast group （ P 〈 0.05 ）. The rate of death was 12.05% in the treated group, and lower than that （ 27.27% ） in the contrast group, but the difference of was not statistical significance （ P 〉 0.05 ）. In the treatment group, the intracranial pressure was steadily controlled, the meningeal irritation was relieved, and the complications were reduced. The curative effect of the treated group was obviously better than that of the contrast group（ P 〈 0.05 ）. Conclusion The effect of the continuous controlled lumbar eerebrospinal fluid drainage in treating the subarachnoid hemorrhage is satisfactory.