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目的探讨创伤性蛛网膜下腔出血的临床治疗方法及治疗措施。方法选择2011年12月至2012年2月在我院神经外科接受治疗的创伤性蛛网膜下腔出血60例患者,所有患者入院后均给予脱水降低颅内压、防止感染、营养支持、对症及应用预防脑血管痉挛的药物等基础治疗,将60例患者随机分为对照组和观察组,对照组实施基础治疗的同时加上脑脊液置换术,观察组在实施基础治疗的同时采取持续性腰大池脑脊液引流治疗创伤性蛛网膜下腔出血,对比两组治疗的结果。结果治疗后对两组的观察项目进行比较,经统计学处理,对照组中,神经功能恢复良好者6例,占20%,中度残疾者10例,占33.3%,重度残疾者7例,占23.3%,死亡者7例,占23.3%;出现并发症的15例,占50%;观察组中,神经功能恢复良好者18例,占60%,中度残疾者8例,占26.7%,重度残疾者3例,占10%,死亡者1例,占3.33%;出现并发症的5例,占16.7%。对照组与观察组患者在死亡率、并发症发生率等方面比较,差异具有统计学意义(P>0.05)。结论治疗创伤性蛛网膜下腔出血时采用持续性腰大池脑脊液引流术可明显降低创伤性蛛网膜下腔出血患者并发症的发生率,而且持续性腰大池脑脊液引流术操作简单,易于操作者掌握,患者恢复效果良好,可显著改善创伤性蛛网膜下腔出血患者的生活质量,提高患者生存率,值得在临床推广应用。
Objective To investigate the clinical treatment and treatment of traumatic subarachnoid hemorrhage. Methods Sixty patients with traumatic subarachnoid hemorrhage undergoing neurosurgery from December 2011 to February 2012 were selected. All patients were given dehydration to reduce intracranial pressure after admission, to prevent infection, nutritional support, symptomatic and 60 cases were randomly divided into control group and observation group. The control group was treated with basic therapy combined with cerebrospinal fluid replacement. The observation group was treated with basic lumbar spine Cerebrospinal fluid drainage for traumatic subarachnoid hemorrhage, compared with the results of two groups of treatment. Results After treatment, the two groups were compared. According to the statistics, in the control group, there were 6 cases with good nerve function recovery in 20%, 10 cases with moderate disability, accounting for 33.3%, 7 cases with severe disability, Accounting for 23.3%, 7 died, accounting for 23.3%; 15 cases of complications, accounting for 50%; observation group, nerve function recovery in 18 cases, 60%, 8 cases of moderate disabilities, accounting for 26.7% , 3 cases of severe disability, accounting for 10%, 1 case of death, accounting for 3.33%; 5 cases of complications, accounting for 16.7%. The difference between the control group and the observation group was statistically significant (P> 0.05) in mortality and complication rates. Conclusion The treatment of traumatic subarachnoid hemorrhage using continuous lumbar drainage of cerebrospinal fluid can significantly reduce the incidence of traumatic subarachnoid hemorrhage in patients with complications, and continuous lumbar cistern cerebrospinal fluid drainage operation is simple and easy for operators to master , Patients with good recovery, can significantly improve the quality of life of patients with traumatic subarachnoid hemorrhage and improve patient survival, it is worth in the clinical application.