终池置管脑脊液持续引流防治创伤性蛛网膜下腔出血后脑血管痉挛

目的 观察终池置管脑脊液(CSF)持续引流防治蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)的疗效.方法 将SAH患者88例,随机分2组:对照组(48例)采用常规治疗加腰穿,治疗组(40例)采用常规治疗加终池置管CSF持续引流.结果 治疗组CSF压力和细胞学检查恢复正常时间较对照组快(P＜0.05),不同时间痉挛指数及脑梗死、死亡的例数、再血发生率明显低于对照组(P＜0.05).2组间疗效评价采用出院时GOS评定,结果显示2组间差异有显著性(P＜0.05).结论 终池置管CSF持续引流防治SAH后CVS疗效确切,能促进神经功能的尽快恢复,减少并发症.

Application of contionuous drainage of cerebrospinal fluid by remaining a tube in terminal cistern in prevention and treatment of traumatic cerebrovascular spasm

Objective To study the curative effect of continuous drainage of cerebrospinal fluid(CSF) through a tube remained in terminal cistern in the treatment of cerebrovasculr spasm(CVS) after subarachnoid hemorrhage(SAH).Methods 88 SAH pations were randomly divided into 2 groups:control group(48) with conventional therapy and lumbar puncture and treatment group(40) with conventional therapy and CSF continuous drainage by remaining a tube in terminal cistern.Results The recovery time of CSF pressure and erythrocyte count in the treatment group is faster than that of the control group(P<0.05).The incidence rates of spasticity index at different time,brain infarct and death in the treatment group are obviously lower than those of the control group(P<0.05).There was no significant difference in view of the re-hemorrhage rate between the two groups(P>0.05).But there was significant difference of therapeutic efficacy between the two groups in GOS when leaving the hospital(P<0.05).Conclusion CSF continuous drainage through remaining a tube in terminal cistern is not only of confirmative effect in the treatment and prevention of CVS after SAH,but also promotes speedy rehabilitation of nerve functions and adds no risk of re-hemorrhage.