脑脊液净化系统治疗动脉瘤性蛛网膜下腔出血的可行性研究

Feasibility study on the curative effect of the cerebrospinal fluid purification system in treatment pa tients with aneurgsmal spontaneous subarachnoid hemorrhage

目的探讨脑脊液净化系统临床应用的性能及用于治疗自发性蛛网膜下腔出血的有效性、安全性,初步评价其临床应用价值。方法治疗组及对照组患者各20例,入院后均行DSA检查明确出血原因为动脉瘤,经神经介入治疗病情稳定后同时采用脱水、止血、抑酸、抑制血管痉挛、镇静止痛、血压控制及防治感染等对症支持治疗21d。治疗组患者通过腰椎穿刺置管连接脑脊液净化系统,连续治疗3d,8次/d,将脑室和蛛网膜下腔内的血性脑脊液分次引流排出。结果两组根据CT影像学变化、脑血管痉挛缓解时间、脑脊液中红细胞数的变化、临床症状的改善情况等进行比较,结果显示治疗组疗效优于对照组(P<0.05)。结论脑脊液净化系统治疗动脉瘤性蛛网膜下腔出血的疗效较显著,可较快减少颅腔内出血量,较早缓解血管痉挛,减轻临床症状。

Objective To investigate the curative effect and safety of cerebrospinal fluid （CSF） purification system in treatment for the patients with aneurgsmal subarachnoid hemorrhage. Methods The lumbar puncture eerebrospinal fluid purification system was connected, fluid purification treatment in accordance with conventional treatment for 3 days, the ventricles and subarachnoid cerebrospi- nal fluid within the sub-sub-drainage of bloody discharge, in order to achieve lower intracranial pres- sure and reduce cerebral vasospasm, reduce the adhesion and AGs of communicating hydrocephalus oc- curred purposes. Results After treatment, reduce the time Fisher classification was that treatment group was （1.7 ! 1.9） d ,P〈0.05, and control group was （4.4 ±1.2） d ,P〈0.05. Cerebral vasospasm （CVS） duration of response was that treatment group was （4.2±1.5） d,P〈0.05, and in control group was （10.4±1.7） d,P〈0.05. CSF red blood cell count returned to normal hours was that treatment group was （9.7±1.8） d,P〈0.05, and control group was （14.2 ±1.4） d,P〈0.05. Delayed ischemie neurological deficit （DIND） duration of response was that treatment group was （10.2±1.9） d,P〈0, 05, and control group was （17.4 ＋ 1.3） d ,P〈0.05. mRS grade reduc- tion time was that treatment group was （9.3±1.7） d ,P〈0.05, and control group was （13.0±1.4） d,P〈0.05. The headache duration of response was that treatment group was （7.1±1.4） d,P d0.05, and control group was （14.2 ± 1.6） d,P〈（0.05. Then the incidence of bleeding and death were no significant differences （P〈0.05）, the total effective than the control group （chi-square value was 6. 144, P〈0. 05. Conclusion The treatment of CSF purification system is an effective and safe method for the patients with aneurismal subarachnoid hemorrhage.