不同置换量对蛛网膜下腔出血脑脊液置换疗效的影响

目的 观察不同置换量对蛛网膜下腔出血脑脊液置换疗效的影响。方法 将60例患者随机分为A组（大量脑脊液置换组）30例、B组（小量脑脊液置换组）30例。对A、B组腰椎穿刺用三通管行脑脊液置换，置换总量A组50～70ml做，B组10～30ml／次。结果头痛缓解时间A组〈B组（P〈0．01）；继发脑血管痉挛、脑积水的发生率A组〈B组（P〈0．05），但再出血的发生率两组差异无显著意义（P〉0．05）；总有效率A组〉B组（P〈0．05）。结论 早期大量脑脊液置换治疗蛛网膜下腔出血的效果优于小量脑脊液置换，但都不能减少再出血的发生。

The effect of different volume cerebrospinal fluid replacement therapy on subarachnoid hemorrhage

Objective To observe the effect of different volume cerebrospinal fluid replacement therapy on subarachnoid hemorrhage. Methods 60 patients were randomly divided into two groups, A group(n=30) and B group (n=30). Patients in A group received cerebrospinal fluid replacement with a total replacement of 50-70ml each time. Patients in B group received cerebrospinal fluid replacement with a total replacement of 10 - 30ml each time.Results The period to relieve headache in A group was shorter significantly than in B group(P<0.01). The incidences of secondary cerebral vascular spasm and hydrocephalus were also significantly lower in A group than in B group(P<0.01, P< 0. 05). However, there was no difference of incidence of secondary hemorrhage between A group and B group( P > 0.05). The total effect rate of A group was significantly higher than that of B group( P<0. 01).Conclusion Large volume cerebrospinal fluid replacement therapy is the more effective and safe therapy for primary subarachnoid hemorrhage at early stage than low volume cerebrospinal fluid replacement therapy,neither of them can redue the occurrence of secondary hemorrhage.