腰池持续引流治疗创伤性蛛网膜下腔出血的临床效果分析

目的探讨腰池持续引流治疗创伤性蛛网膜下腔出血的疗效。方法111例患者随机分为对照组于伤后第2d起每天腰穿放液,生理盐水置换脑脊液(CSF),鞘内注入氧气;治疗组于伤后第2d行腰池持续引流,观察两组患者的清醒时间和住院时间、并发症和预后情况。结果对照组清醒时间和住院时间明显长于治疗组(P<0.05～P<0.01);治疗组脑积水、脑梗塞及再出血的发生率较对照组明显减少(P<0.01);治疗组在死亡病例、重残率、中残率及恢复的良好率等方面均显著优于对照组(P<0.05)。结论腰池持续引流是治疗创伤性蛛网膜下腔出血的较好方法,值得临床推广应用。

Clinical Effects of Continuous Drainage of Cerebrospinal Fluid in Lumbar Cistern on Patients With Traumatic Subarachnoid Hemorrhage

Objective To analyze the effects of continuous drainage of cerebrospinal fluid in lumbar cistern on patients with traumatic subarachnoid hemorrhage (tSAH). Methods 111 patients with tSAH were randomized into control and treatment group. Patients in the control group underwent lumber puncture, cerebrospinal fluid (CSF) were changed with physiological saline (N.S), and oxygen were injected into sheath; and patients in treatment group received additional continuous drainage of cerebrospinal fluid in lumbar cistern. All treatment performed at 2nd day after injured. The time of regain consciousness, days in hospital, complications and prognosis were observed. Results Time of regain consciousness and days in hospital were evidently longer in control group than in treatment group ( P <0.05 or P <0.01). Compared with control group, the hydrocephalus, cerebral infarction and re-hemorrhage decreased significantly ( P <0.01), the difference of mortality, middling and severe deformity and the prognosis between treatment group and control group were significantly. The treatment group was markedly excelled. Conclusions Continuous drainage of cerebrospinal fluid in lumbar cistern is a preferable therapy for traumatic subarachnoid hemorrhage and worth to use.