尼莫地平鞘内注射脑脊液置换术治疗创伤性蛛网膜下腔出血的临床疗效分析

目的：从临床疗效及安全性方面分析尼莫地平鞘内注射脑脊液置换术治疗创伤性蛛网膜下腔出血的可行性。方法以数表法随机将收治的98例重型颅脑损伤伴蛛网膜下腔出血患者分为观察组和对照组，每组各49例。两组均行常规支持对症治疗，观察组加用尼莫地平鞘内注射脑脊液置换术，比较两组临床的结局差异。结果两组比较，观察组的格拉斯哥昏迷评分（GCS）良好率显著提高（P〈0.05），血性脑脊液消失时间、临床体征及平均住院时间均显著缩短（P〈0.05），出现脑血管痉挛、脑积水以及脑梗死的比率均显著降低，差异有统计学意义（P〈0.05）。结论尼莫地平鞘内注射脑脊液置换术对于重型颅脑损伤伴蛛网膜下腔出血患者疗效显著，可较快消除血性脑脊液，减轻疼痛症状且并发症较少，简单易行，值得基层医院推广应用。

ObjectiveTo analyze the feasibility of the treatment of traumatic subarachnoid hemorrhage by injecting cerebrospinal fluid replacement.Methods 98 cases of severe craniocerebral injury with subarachnoid hemorrhage were divided into observation group and control group randomly with 49 cases in each group. The two groups were all treated with routine support,the observation group was treated with nimodipine intrathecal injection of cerebrospinal fluid replacement,and compared the clinical outcome of the two groups.ResultsBetween the two groups, the observation group of GCS score good rate increased significantly（P〈0.05）and cerebrospinal fluid of courage and uprightness disappear time, clinical signs and the average hospitalization time shortened significantly（P〈0.05）and brain vascular spasm,brain water and cerebral infarction ratio were significantly lower,the difference was statistically significant（P〈0.05）.ConclusionsNimodipine intrathecal injection of cerebrospinal fluid replacement for severe craniocerebral injury patients with subarachnoid hemorrhage patients with obvious curative effect,can rapidly eliminate cerebrospinal fluid of courage and uprightness,relieve pain and less complications is simple,so it is worthy of popularization and application in basic level hospital.