腰大池持续外引流合并鞘内注射尿激酶治疗脑血管痉挛的临床效果

目的 探讨鞘内局部注射尿激酶治疗蛛网膜下腔出血后脑血管痉挛的疗效.方法 将动脉瘤性蛛网膜下腔出血患者随机分为对照组和实验组,对照组采用常规综合治疗加静脉泵入尼莫地平治疗,实验组在对照组的基础上放置腰大池引流管并脑池内注射尿激酶治疗,通过观察病情变化评价两组的治疗疗效.结果 实验组剧烈头痛、恶心呕吐、意识障碍及脑膜刺激征等主要症状及体征的缓解率明显高于对照组(P＜0.05),实验组(5/26)脑血管痉挛发生率明显低于对照组(10/24,P＜0.05).结论 早期鞘内注射尿激酶并持续外引流防治脑血管痉挛的效果良好,且术后脑积水的并发症少.

The clinical study of the treatment of cerebral vasospasm with persistent lumbar draining and intrathecal injection of urokinase

Objective To investigate the therapeutic effect on treatment of cerebral vasospasm after subarachnoid hemorrhage with intrathecal injection of urokinase. Methods Patients with aneurysmal subarachnoid hemorrhage were randomly divided into two groups, the overall control group with conventional therapy plus intravenous Nimodipine treatment, while the experimental group, on the basis of the control group treatment, were placed with lumbar draining and injected with urokinase.All patients were evaluated by the patient’s condition. Results The remission rate of headache,nausea, vomiting,unconsciousness,and meningeal irritation in the experimental group was significantly higher than those in the control group(P<0.05),while the incidence rate of CVS(5/26) was significantly lower than that of the control group (10/24,P<0.05). Conclusion Early intrathecal injection of urokinase and persistent drainage of cerebrospinal fluid could prevent and relieve of cerebral vasospasm, and reduce the incidence rate of hydrocephalus.