脑脊液置换治疗蛛网膜下腔出血的疗效分析  

Analysis of different amount of cerebrospinal fluid replacement in the treatment of subarachnoid hemorrhage

作　　者：袁胜山[1] 黄建敏[1] 蒙兰青[1] 梁雄壮[1] 潘耀新[1] 黄晓华[1] 

机构地区：[1]右江民族医学院附属医院神经内科,广西百色533000

出　　处：《右江医学》2010年第5期534-536,共3页Chinese Youjiang Medical Journal

摘　　要：目的分析不同量脑脊液置换治疗蛛网膜下腔出血（SAH）的效果。方法将102例蛛网膜下腔出血患者根据是否行脑脊液置换及置换量的多少分为少量置换组（A组,n=36）、大量置换组（B组,n=36）及一般治疗组（C组,n=30）,置换组除了给予一般治疗组同样的治疗方法外,通过简易腰穿法,以不同量生理盐水缓慢置换脑脊液,A组10~30 ml/次,B组40~70 ml/次。结果置换组平均头痛缓解时间显著缩短（P〈0.01）,大量置换组较少量置换组平均头痛缓解时间缩短更显著（P〈0.05）;大量置换组脑血管痉挛及脑积水发生率均显著低于一般治疗组（P〈0.05）。结论早期简易腰穿脑脊液置换治疗SAH可以缩短患者头痛时间,大量脑脊液置换不仅可以更有效缩短头痛时间,还可以减少其脑积水、脑血管痉挛并发症。Objective To explore the curative effects of exchange of cerebrospinal fluid （CSF） with different amount of 0. 9% sodium chloride for the treatment of subarachnoid hemorrhage（SAH）. Methods One hundred and two SAH patients diagnosed by CT and lumbar puncture were divided into three groups： 36 patients in the treatment group were given exchange of CSF with 10- 30ml 0.9 % sodium chloride （group A）, and another 36 patients in the treatment group with 40- 70ml 0.9 % sodium chloride （group B） ;30 patients in the control group were treated with- out exchange of CSF （group C）. Headache disappear time, the main complications and curative effect of the three group were compared. Results Headache disappear time was shorten in treatment group more than that in control group,and there was obvious difference in the two treatment groups （ P 〈0.05）. Complications about cerebral vasopasm and hydrocephalus in group B were fewer than those in the conventional therapeutic group（ P 〈0.05）. Conclusion CSF exchanging in early stage can shorten the headache disappear time of SAH patients,and a large number of CSF replacement can not only reduce the headache of time more effectively, but also reduce the hydrocephalus and cerebral vasospasm complications incidence significantly.

关 键 词：蛛网膜下腔出血 脑脊液 置换 

分 类 号：R743.35[医药卫生—神经病学与精神病学]