腰穿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 观察腰穿置管脑脊液（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，随机分两组。对照组（48例）采用常规治疗加腰穿。治疗组（40例）采用常规治疗加腰穿置管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、再出血发生率明显低于对照组（P〈0．05）。两组间疗效评价采用出院时GOS评定，显示两组间有明显差别（P〈0．05）。结论 腰穿置管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 continuous drainage of cerebrospinal fluid by remaining a tube after lumbar puncture 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 lumbar in the treatment of cerebrovascular spasm (CVS) after subarachnoid hemorrhage (SAH). Methods 88 SAH patients 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 after lumbar puncture. Results The recovery time of CSF pressure and erythrocyte count in the treatment group is faster than that of 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 re-hemorrhage rate between the two groups (P>0.05), but significant difference of therapeutic efficacy between the two groups in GOS when leaving the hospital (P<0.05). Conclusion CSF continuous drainage by lumbar puncture and remaining a tube 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.