腰椎穿刺蛛网膜下腔置管持续引流防治脑血管痉挛的初步观察

目的：探讨腰椎蛛网膜下腔置管持续引流对蛛网膜下腔出血（SAH）后脑血管痉挛的预防与治疗效果。方法：对88例颅内动脉瘤性SAH患，在超早期行电解可脱卸弹簧圈（GDC）栓塞术后，实施腰椎蛛网膜下腔置管持续引流，通过临床症状、经颅多普勒超声（TCD）及脑血管造影、ECT判断血管痉挛的发生率及严重程度。结果：11例出现症状性脑血管痉挛，平均随访11个月，恢复良好10例，中度致残1例。无引流相关并发症。结论：腰椎蛛网膜下腔置管持续引流可以清除蛛网膜下腔积血、引流血管收缩物质,预防血管痉挛的发生及缓解痉挛程度。

Prevention of cerebral vasospasm by lumbar subarachnoid continuous drainage: a preliminary study

Objective: : To study the prevention of cerebral vasospasm following subarachnoid hemorrhage by lumbar subarachnoid continuous drainage. Methods: Lumbar cont inuous subarachnoid drainage was instituted after ruptured aneurysms were emboli zed with GDC at early stage. The incidence and degree of vasospasm was estimated through clinical manifestation, TCD, ECT and DSA. Results: Amon g these patients, 11 patients experienced cerebral vasospasm. All patients were followed up for an average of 11 months, 10 patients recovered well, one had mod erate neurological deficit. There was no complication related to continuous drai nage. Conclusion: Lumbar continuous drainage may decrease the in cidence of cerebral vasospasm by removing subarachnoid clot and eradicating vaso genic factors.