腰穿置管稳压引流治疗蛛网膜下腔出血后脑积水

Treatment of hydrocephalus after subarachnoid hemorrhage with lumbar puncture steady-pressure drainage

目的探讨蛛网膜下腔出血(SAH)后脑积水简便、安全、有效的治疗方法。方法所收治的283例SAH病人中有90例发生了急性脑积水,在内科治疗基础上,其中46例进行了腰穿置管稳压引流治疗结果与无脑积水者对照比较。结果上法治疗后32例(32/46,70%)意识水平均有所改善;所有受治病人12d内再出血和脑缺血的发生率与无脑积水的病人组无显著性差异〔5/46(11%),24/193(12%);16/46(35%)60/193(31%)。P>0.05〕。治疗组未发生脑室炎或脑膜炎。结论腰穿置管稳压引流是一种治疗SAH后脑积水简便、安全、有效的方法。

Objective To study an effective treatment for hydrocephalus after subarachnoid hemorrhage(SAH). Methods There were 90 patients with acute hydrocephalus in 283 patients with SAH. Besides medical treatment,lumbar puncture steady-pressure drainage of cerebrospinal fluid(CSF) was performed in 46 of the 90 patients; their treatment outcomes were compared with that of the patients without hydrocephalus.Results The 32 of the 46 paitents achived improvement in the level of consciousness; the rebleeding and cerebral ischemia rate within 12 days after SAH in patients with hydrocephalus was not significantly higher than the rate in those without hydrocephalus[5/46(11%) 24/193(12%);16/46(35%) 60/193(31%).P>0.05]. Neither meningitis nor ventriculitis was observed in the 46 patients. Conclusion The lumbar puncture steady-pressure drainage of CSF would be a safe, effective method for treatment of hydrocephalus after SAH.