创伤性蛛网膜下腔出血50例治疗体会.docVIP

创伤性蛛网膜下腔出血50例治疗体会 　　摘 要 目的：探讨持续腰大池引流治疗创伤性蛛网膜下腔出血临床治疗效果。方法：收治创伤性蛛网膜下腔出血患者100例，随机分成对照组和观察组各50例，对照组采取间断腰椎穿刺生理盐水置换脑脊液。观察组采取持续腰大池引流治疗。结果：观察组发生蛛网膜下腔再出血6例，发生脑积水7例，发生脑梗死6例；对照组发生蛛网膜下腔再出血13例，发生脑积水16例，发生脑梗死12例。两组比较差异有统计学意义（P0.05），两组随访6个月，对照组良好22例，中残9例，重残5例，植物生存4例，死亡10例；观察组良好30例，中残7例，重残3例，植物生存3例，死亡7例，两组比较差异有统计学意义（P0.05）。结论：持续腰大池引流治疗创伤性蛛网膜下腔出血疗效显著。 　　关键词 腰大池引流 创伤性蛛网膜下腔出血 腰椎穿刺 　　Abstract Objective：To study the effect of continuous lumbar cistern drainage in treatment of traumatic subarachnoid hemorrhage.Methods：We selected 100 cases of traumatic subarachnoid hemorrhage patients from 2010 June to 2013 June.These patients were randomly divided into observation group and control group with 50 cases in each.The control group adopted discontinuous lumbar puncture to exchange cerebrospinal fluid with physiological saline.The observation group adopted continuous lumbar cistern drainage.Results：The observation group occurred again subarachnoid hemorrhage in 6 patients， hydrocephalus in 7 cases and cerebral infarction in 6 cases.The control group occurred again subarachnoid hemorrhage in 13 patients，hydrocephalus in 16 cases and cerebral infarction in 12 cases.The difference between the two groups was significant （P0.05）.Follow up of 6 months，The control group patients had good effect 22 cases，moderate disability 9 cases，severe disability 5 cases，vegetative patient 4 cases and death 10 cases.The observation group patients had good effect 30 cases，moderate disability 7 cases，severe disability 3 cases，vegetative patient 3 cases and death 7 cases.The difference between the two groups was significant（P0.05）.Conclusion：The effect of continuous lumbar cistern drainage in the treatment of traumatic subarachnoid hemorrhage is remarkable and is is worth spreading. 　　Key words Lumbar cistern drainage；Traumatic subarachnoid hemorrhage；Lumbar puncture 　　创伤性蛛网膜下腔出血（TSA）临床上比较常见[1]，是导致脑损伤后加重继发脑损伤的主要因素[2]，及时正确的治疗对预后有着重要的意义。近年来，采用持续腰大池引流治疗取得了较好的临床效果，现报告如下。 　　资料与方法 　　2010年6月-2013年6月收治创伤性蛛网膜下腔出血患