腰池置管脑脊液外引流术联合注入尿激酶治疗重症蛛网膜下腔出血

目的探讨腰池置管脑脊液持续外引流术联合注入尿激酶治疗重症蛛网膜下腔出血(SAH)的临床疗效。方法将2002年1月-2003年6月28例SAH患者为观察组应用腰池置管脑脊液外引流术并联合椎管注入尿激酶;2000年3月-2001年12月20例应用腰穿脑脊液置换术者为对照组。结果 蛛网膜下腔积血清除时间观察组较对照组短(P<0.01):头痛缓解时间观察组较对照组快(P<0.01);意识障碍时间观察组较对照组短(P<0.01);CSF压力下降时间较对照组短(P<0.01);明显降低再出血、脑血管痉挛、脑积水三大并发症的发生率。结论采用腰池置管脑脊液外引流术联合椎管注入尿激酶治疗重症蛛网膜下腔出血疗效优于腰穿脑脊液置换术。

Drainage Combined with Pouring into urokinase for Treating Serious Subarachnoid Hemorrhage

Objective To explore the clinic effect of continuing drainage of cerebrospinal fluid (CSF) by terminal cistern inserted tube, combined with pouring into urokinase treating serious subarachnoid hemorrhage (SAH) . Methods 28 cases of SAH patients were taken for the observe group from January 2002 to Jane 2003,applied terminal cistern inserted tube, combined with pouring into urokinase; 20 cases patients of applying CSF replacement by lumber puncture were taken for the control group.Results The observe group was shorter than the control group in cleaning time of SA stagnant blood (P<0.01) ;the observe group was quicker than the control in reducing headache time (P<0.01) ;the observe group was shorter than the control group in coma time (P<0.01) ;the observe group was shorter than the control group in decreasing intracranial pressure,cleaning bloody CSF time (P<0.01) ;It could reduce obviously three major complications of rehemorrhage.cerebrovascular convulsion, brain stagnant water. Conclusions the effect of adopting drainage of CSF by terminal cistern inserted tube, combined with pouring into urokinase treating serious SAH was better than CSF replacement by lumber puncture.