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  

Application of continuous drainage of cerebrospinal fluid by remaining a tube after lumbar puncture in prevention and treatment of traumatic cerebrovascular spasm

作　　者：宁球 林志霞 马晓春 黎坤境 

机构地区：[1]广州市番禺区大石人民医院脑外科,511430

出　　处：《中华神经医学杂志》2005年第8期813-815,共3页Chinese Journal of Neuromedicine

摘　　要：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(SA H)后脑血管痉挛(CV S)的疗效。方法将SA H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G O S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SA H后CV S疗效确切,能促进神经功能的尽快恢复,减少并发症。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.

关 键 词：蛛网膜下腔出血 血管痉挛 颅内 脑脊液引流 

分 类 号：R651.1[医药卫生—外科学]