持续腰大池引流联合脑脊液置换治疗蛛网膜下腔出血的研究

Study of treatment of continuous lapara cisterna magna drainage and cerebrospinal fluid replacement in subarachnoid hemorrhage

目的:观察腰大池引流联合脑脊液置换治疗蛛网膜下腔出血(SAH)的疗效。方法:将96例蛛网膜下腔出血患者随机分为对照组和治疗组,对照组采用常规的降颅压等治疗,治疗组在常规降颅压等治疗的基础上行持续腰池引流联合脑脊液置换治疗,对两组治疗方法的治疗效果进行评估。结果:治疗组脑积水发生率(5%)、脑血管痉挛发生率(14.40%)较对照组脑积水发生率(12%)、脑血管痉挛发生率(48.32%)明显降低(P<0.05或P<0.01),临床神经功能缺损程度评分及日常生活能力评分治疗组明显提高,差异有统计学意义(P<0.05或P<0.01)。结论:腰大池引流联合脑脊液置换治疗SAH能加快血性脑脊液的廓清,减少血液中活性物质的刺激,降低并发症的发生,提高生存率,改善预后。

Objective： To study curative effect of the therapy of lapara cisterna magna drainage and cerebrospinal fluid replacement in subarachnoid hemorrhage（SAH）.Methods： The cases of subarachnoid hemorrhage patients were randomly divided into treatment group and control group,treatment effects of the method were evaluated.Results： The rate of hydrocephalus was 5% and the rate of cerebral vasospasm was 14.40% in treatment group,but the rate of hydrocephalus was 12% and the rate of cerebral vasospasm was 48.32% in control group（P〈0.05 or P〈0.01）.Clinical neurological defect score and the ADL score were obviously improved in treatment group（P〈0.05 or P〈0.01）.Conclusion： The treatment of continuous waist pool drainage and cerebrospinal fluid replacement in subarachnoid hemorrhage can speed up the clearance of bloody cerebrospinal fluid,reduce the complications,improve survival rate and the prognosis.