腰大池持续外引流术在创伤性蛛网膜下腔出血中的应用效果观察  

Application of continuous lumbar drainage on traumatic subarachnoid hemorrhage

作　　者：张传东[1] 仇洪[1] 兰展 冯磊[1] 韦继明[1] ZHANG Chuan-dong;QIU Hong;LAN Zhan(Department of Neurosurgery,the People′s Hospital of Hechi City,Guangxi 547000,China)

机构地区：[1]河池市人民医院神经外科,广西547000

出　　处：《中国临床新医学》2019年第1期39-42,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西河池市科学研究与技术开发计划项目(编号:河科推-1549-5)

摘　　要：目的探讨腰大池持续外引流术在创伤性蛛网膜下腔出血中的应用效果。方法将50例创伤性蛛网膜下腔出血患者按随机数字表法分为对照组和观察组,每组25例。对照组行腰椎穿刺术治疗,观察组行腰大池持续外引流术治疗。观察比较两组患者在不同时间段脑CT灌注成像的脑血容量(CBV)、脑血流量(CBF)、对比剂达峰时间(TTP)、对比剂平均通过时间(MTT)的参数变化以及脑脊液内皮素-1(ET-1)、一氧化氮(NO)水平。结果治疗后第7天、第14天,观察组CBV、CBF、NO水平明显高于对照组,TTP、MTT、ET-1水平明显低于对照组,差异有统计学意义(P=0.000)。结论创伤性蛛网膜下腔出血会诱发脑血管痉挛,腰大池持续外引流术能快速廓清血性脑脊液,缓解脑血管痉挛,改善脑血流灌注,改善患者预后。Objective To investigate the effect of continuous lumbar drainage on traumatic subarachnoid hemorrhage.Methods Fifty patients with traumatic subarachnoid hemorrhage were divided the control group and observation group by random number table method,25 cases in each group.The control group received lumbar puncture treatment,and the observation group was treated with continuous lumbar drainage.The parameters of cerebral blood volnine(CBV),cerebral blood flow(CBF),time to peak(TTP),mean transit time(MTT)in cerebral computed tomography(CT)perfusion imaging at different time points and the levels of endothelin-1(ET-1),nitric oxidex(NO)in the cerebrospinal fluid were compared between the two groups.Results The parameters of CBV,CBF and NO in the observation group were obviously higher than those in the control group 7 and 14 days after treatment.The levels of TTP,MTT,ET-1 in the observation group were obviously lower than those in the control group 7 and 14 days after treatment(P=0.000).Conclusion Traumatic subarachnoid hemorrhage can induce cerebral vasospasm,and the continuous lumbar drainage can quickly remove the hemorrhagic cerebrospinal fluid to relieve the cerebral vasospasm,and improve cerebral blood perfusion and the prognosis of the patients.

关 键 词：腰大池持续外引流术 创伤性蛛网膜下腔出血 脑血管痉挛 脑CT灌注成像 脑脊液内皮素-1 一氧化氮 

分 类 号：R743.35[医药卫生—神经病学与精神病学]