鞘内注射地塞米松联合脑脊液置换术治疗蛛网膜下腔出血疗效观察  

Effects of intrathecal injection of dexamethasone combined with cerebrospinal fluid replacement in the treatment of subarachnoid hemorrhage

作　　者：谢昭太 陆四方 蔡叶盛 XIE Zhao-tai;LU Si-fang;CAI Ye-sheng(Brain Center,Ciyun Hospital of Jieyang City,Jieyang 522031,Guangdong,CHINA)

机构地区：[1]揭阳市慈云医院脑科中心,广东揭阳522031

出　　处：《海南医学》2018年第14期1963-1965,共3页Hainan Medical Journal

摘　　要：目的观察鞘内注射地塞米松联合脑脊液置换术治疗蛛网膜下腔出血(SAH)的临床疗效。方法将揭阳市慈云医院2015年2月至2017年5月期间收治的100例SAH患者,采用随机数表法分为观察组(n=50)与对照组(n=50),对照组给予常规治疗,观察组在对照组基础上给予鞘内注射地塞米松联合脑脊液置换术治疗,比较两组患者的临床症状缓解时间、脑脊液血红蛋白清除时间、临床疗效及并发症发生率。结果观察组患者的头痛消失时间、恶心呕吐消失时间、颈项强直消失时间、体温恢复正常时间、脑脊液血红蛋白清除时间分别为(6.7±1.2)d、(5.4±1.4)d、(12.7±1.2)d、(5.7±1.9)d、(7.3±1.4)d,均短于对照组的(12.3±1.3)d、(9.9±1.3)d、(19.1±1.1)d、(10.1±1.8)d、(16.7±1.5)d,差异均有统计学意义(P<0.05);观察组患者治疗总有效率为96.0%,高于对照组的64.0%,差异有统计学意义(P<0.05);观察组患者的脑梗死、脑积水、脑血管痉挛发生率分别为6.0%、6.0%、8.0%,均低于对照组的26.0%、32.0%、26.0%,差异均有统计学意义(P<0.05);观察组与对照组患者的再出血发生率(6.0%vs 8.0%)比较差异无统计学意义(P>0.05)。结论鞘内注射地塞米松联合脑脊液置换术治疗SAH疗效显著,其可缓解患者的临床症状快,降低并发症发生率。Objective To discuss the effect of intrathecal injection of dexamethasone combined with cerebrospinal fluid replacement in the treatment of subarachnoid hemorrhage. Methods One hundred patients with subarachnoid hemorrhage in Ciyun Hospital of Jieyang City from Feb. 2015 to May 2017 were divided into the observation group（n=50） and the control group（n=50）, which were treated with conventional therapy and intrathecal injection of dexamethasone combined with cerebrospinal fluid replacement on the basis of the control group. Then the time of remission of clinical symptoms, the scavenging time of cerebrospinal fluid hemoglobin, the clinical effect, and the incidence of complications were compared between the two groups. Results The headache disappearance time, nausea and vomiting disappear time, neck stiffness disappear time, body temperature recovery time, and the scavenging time of cerebrospinal fluid hemoglobin in the observation group were（6.7±1.2） d,（5.4±1.4） d,（12.7±1.2） d,（5.7±1.9） d,（7.3±1.4） d, significantly shorter than（12.3±1.3） d,（9.9±1.3） d,（19.1±1.1） d,（10.1±1.8） d,（16.7±1.5） d in the control group（P〈0.05）. The effective rate of treatment in the observation group was 96.0%, significantly higher than 64.0% in the control group（P〈0.05）. The incidence of cerebral infarction, hydrocephalus, cerebral vasospasm in the observation group were 6.0%,6.0%, 8.0%, significantly lower than 26.0%, 32.0%, 26.0% in the control group（P〈0.05）. There was no significant difference in the incidence of rehaemorrhagia between the two groups（6.0% vs 8.0%, P〉0.05）. Conclusion Intrathecal injection of dexamethasone combined with cerebrospinal fluid replacement in the treatment of subarachnoid hemorrhage is effective. It can relieve the clinical symptoms, reduce the incidence of complications, and relieve the pain of patients.

关 键 词：鞘内注射地塞米松 脑脊液置换术 蛛网膜下腔出血 疗效 

分 类 号：R743.35[医药卫生—神经病学与精神病学]