早期腰大池引流与腰椎穿刺脑脊液置换对蛛网膜下腔出血患者血管痉挛的影响  

Effects of early lumbar cistern drainage and lumbar puncture cerebrospinal fluid replacement on vasospasm in patients with subarachnoid hemorrhage

作　　者：肖化选 罗洪海[1] 陈伟平 戴兵 邓一帆[1] XIAO Hua-xuan;LUO Hong-hai;CHEN Wei-ping(Department of neurosurgery,boruo branch,huizhou central people's hospital,huizhou,516100,China)

机构地区：[1]惠州市中心人民医院博罗分院神经外科,广东惠州516100

出　　处：《吉林医学》2021年第3期550-552,共3页Jilin Medical Journal

摘　　要：目的:探讨对蛛网膜下腔出血(SAH)患者,在出血后24 h内分别给予腰大池引流脑脊液置换与腰椎穿刺脑脊液置换对血管痉挛的影响。方法:选取70例SAH分成两组,35例对照组采取常规腰椎穿刺脑脊液置换法,35例研究组采取腰大池引流脑脊液置换法,比较两组干预效果。结果:研究组血管痉挛发生率为5.71%,明显低于对照组22.86%的发生率,差异有统计学意义(P<0.05);研究组在脑脊液廓清时间、脑膜刺激征消失时间及头痛症状缓解时间上均短于对照组,差异有统计学意义(P<0.05);相关并发症的总发生率上两组对比差异无统计学意义(P>0.05)。结论:对SAH患者,早期采取腰大池引流脑脊液置换可取得较满意的效果,促进症状的改善及降低血管痉挛的发生率,值得推广。Objective To investigate the effects of lumbar cistern drainage cerebrospinal fluid replacement and lumbar puncture cerebrospinal fluid replacement on vasospasm in patients with subarachnoid hemorrhage(SAH)within 24 hours after the hemorrhage.Method 70 cases of SAH were divided into two groups,35 cases in the control group were treated with routine lumbar puncture CSF replacement,and 35 cases in the research group were treated with lumbar cisterna drainage CSF replacement.The intervention effects of the two groups were compared.Results The incidence of vasospasm in the study group was 5.71%,which was significantly lower than 22.86%of in the control group(P<0.05).The clearance time of CSF,the disappearance time of meningeal stimulation and the relief time of headache were shorter in the study group than in the control group(P<0.05).There was no statistically significant difference in the total incidence of related complications between the two groups(P>0.05).Conclusion For SAH patients,early lumbar cistern drainage of cerebrospinal fluid replacement can achieve a satisfactory effect,promote the improvement of symptoms and reduce the incidence of vasospasm,it is worth promoting.

关 键 词：腰大池引流 腰椎穿刺 脑脊液置换 蛛网膜下腔出血 血管痉挛 

分 类 号：R743.35[医药卫生—神经病学与精神病学]