腰穿脑脊液置换治疗蛛网膜下腔出血的临床观察

Clinical observation of cerebrospinal fluid displacement with lumbar puncture for treating subarachnoid hemorrhage

目的 观察腰穿 CSF置换治疗 SAH的疗效。方法 治疗组行腰穿放出 CSF10 ml,再注入生理盐水 8ml,重复2～ 4遍后加地塞米松 10 mg鞘内注入。 2天重复 1次。结果 治疗组头痛迅速缓解 ,平均 4.86天 ,对照组 15 .2 0天 ;脑膜刺激征消失 ,治疗组平均 7.94天 ,对照组 15 .5 7天 ;CVS治疗组 1例 ,对照组 6例 ,治疗组死亡 2例 ,对照组死亡 7例。结论 腰穿 CSF置换是治疗 SAH的一种简单、安全、有效的方法 ,可全面缓解症状和体征 ,减少 CVS的发生和病死率。

Objective To observe the efficacy of cerebrospinal fluid displacement with lumbar puncture for treating subarachnoid hemorrhage(SAH).Methods In the treatment group(n=32),by means of lumbar puncture,10ml of CSF were released and 8ml of aspetic physiological saline were injected.After repeating 2～4 times,10mg of dexamethasone were injected intrathecally.This displacement procedure was performed every 2 days.The control group consisted of 30 patients not subjected to the displacement procedure.Results [WT5”BZ]The patients of the treatment group were relieved of their headache more rapidly(averaged 4.86 days vs.15.20 days of the control group)and their meningismus disappeared(averaged 7.94 days vs.15.57 days of the control group).Cerebrovascular spasm occurred in 1 patient of the treatment group and 6 patients of the control group.There were 2 deaths in the treatment group and 7 in the control group.Conclusion CSF displacement with lumbar puncture is a simple,safe and effective method of treating SAH.It can generally improve the symptoms and signs and decrease the onset of cerebrovascular spasm and death rate.