持续腰大池引流对外伤性蛛网膜下腔出血患者早期康复的影响  

Effect of Continuous Lumbar Drainage on Early Rehabilitation of Patients with Traumatic Subarachnoid Hemorrhage

作　　者：张善纲[1] 杜浩[2] 梁音[3] 赵力力[1] 

机构地区：[1]广州军区武汉总医院康复理疗科,湖北武汉430070 [2]广州军区武汉总医院神经外科,湖北武汉430070 [3]武汉市医疗救治中心,湖北武汉430023

出　　处：《中国临床神经外科杂志》2009年第8期468-470,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨早期行持续性腰大池引流术对外伤性蛛网膜下腔出血(tSAH)患者康复治疗效果。方法符合纳入标准的51例tSAH患者按随机数字表分为观察组(22例)与对照组(29例),两组均给予常规康复治疗,观察组并给予常规腰大池置管引流,置管3～5 d。入组时及术后2 d分别评定两组患者头痛的程度、脑膜刺激征、脑脊液红细胞计数(CSF-RBC),并在入组时及术后1个月按功能综合评定量表(FCA)评定患者的综合功能,比较两组症状、体征、CSF-RBC及FCA评分改善程度,分析FCA评分改善程度与CSF-RBC的相关性。结果观察组2 d内反映头痛程度的视觉模拟评分及反映脑膜刺激征的胸颌距明显减少,CSF-RBC明显下降,2日下降(59±25)%,1个月内FCA总分明显增加,上述指标均高于对照组(P<0.05);观察组FCA评分与CSF-RBC呈明显负相关(P<0.01)。结论行持续性腰大池引流术有助于tSAH患者早期综合功能的康复。Objectives To explore the effect of continuous lumbar drainage on the early rehabilitation of patients with traumatic subarachnoid hemorrhage （tSAH）. Methods Fifty-one patients with tSAH were randomly divided into both the observed group （22 cases） and control group （29 cases）. The routine rehabilitation treatment was performed in both the groups, and the observed group received continuous lumbar drainage from 3 to 5 days. Headache, sign of meningeal irritation assessed by the distance from the sternum to the chin and the number of red blood cells in cerebrospinal fluid （CSF-RBC） were examined in both the groups just before and 2 days after the treatment. The comprehensive function wad assessed in both the groups before and 1 month after the treatment according to Functional Comprehensive Assessment （FCA）. The outcomes of the above-mentioned examinations were compared between both the groups. The relationship between the comprehensive function and the change in the number of CSF-RBC was analyzed. Results The score of visual analogue scales showed that headache was significantly relieved, the distance from the sternum to the chin was significantly reduced and the number of CSF-RBC was significantly reduced in the observed group 2 days after the treatment compared to those before the treatment and in the control group （P〈0.05）. The comprehensive function was significantly better in the observed group than that in the control group 1 month after the treatment （P〈0.01）. The comprehensive function was negatively related to the number of CSF-RBC in the observed group （P〈0.01）. Conclusion The continuous lumbar drainage is helpful to the comprehensive function rehabilitation in patients with traumatic tSAH.

关 键 词：颅脑损伤 蛛网膜下腔出血 功能综合评定量表 持续腰大池引流术 康复 

分 类 号：R615.15[医药卫生—外科学] R743.35[医药卫生—临床医学]