血性脑脊液早期引流对重症动脉瘤性蛛网膜下腔出血患者预后的影响

目的探讨早期引流血性脑脊液对重症动脉瘤性蛛网膜下腔出血（saSAH）预后的影响。方法将36saSAH急性期患者随机分成腰大池引流组和间断腰蛛网膜下腔穿刺组，两组均给予常规药物和早期动脉瘤介入栓塞或手术夹闭治疗，比较两组急性生理学和慢性健康状况Ⅱ评分（APACHEⅡ）、重症监护室住院周期、脑积水并发症发生率、改良Rankin量表（MRS）评分。结果腰大池引流组APACHEⅡ评分、重症监护室住院周期、脑积水并发症发生率、MRS评分均优于间断腰蛛网膜下腔穿刺组。结论saSAH患者术后早期通过腰大池持续引流血性脑脊液疗效显著，操作简便、安全，可改善患者预后。

Objective To study the effect of early drainage of bloody cerebrospinal fluid on the prognosis of severe aneurysmal subarachnoid hemorrhage. Methods 36 patients with saSAH in acute stage were enrolled in the study, which were randomly divided into two groups with 18 cases in each, one group was treated by continuous lumbar drainage and the other group by discontinuous lumbar puncture. Routine medicine and interventional embolization or surgical clipping in acute stage were given in two groups. The two groups were compared with APACHEⅡ, length of stay in NICU, incidence rate of hydrocephalus and MRS. Results The degree of APACHEⅡ, length of stay in NICU, incidence rate of hydrocephalus and MRS in the group of continuous lumbar drainage were much better than the other group. Conclusion The continuous lumbar drainage for saSAH in early stage was effectively. And it was easy and simple to handle, safety and improved the prognosis.