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目的:观察腰大池引流联合脑脊液置换治疗蛛网膜下腔出血(SAH)的疗效。方法:将96例蛛网膜下腔出血患者随机分为对照组和治疗组,对照组采用常规的降颅压等治疗,治疗组在常规降颅压等治疗的基础上行持续腰池引流联合脑脊液置换治疗,对两组治疗方法的治疗效果进行评估。结果:治疗组脑积水发生率(5%)、脑血管痉挛发生率(14.40%)较对照组脑积水发生率(12%)、脑血管痉挛发生率(48.32%)明显降低(P<0.05或P<0.01),临床神经功能缺损程度评分及日常生活能力评分治疗组明显提高,差异有统计学意义(P<0.05或P<0.01)。结论:腰大池引流联合脑脊液置换治疗SAH能加快血性脑脊液的廓清,减少血液中活性物质的刺激,降低并发症的发生,提高生存率,改善预后。
Objective: To observe the effect of lumbar drainage combined with cerebrospinal fluid replacement for treatment of subarachnoid hemorrhage (SAH). Methods: Ninety-six patients with subarachnoid hemorrhage were randomly divided into control group and treatment group. The control group was treated with conventional intracranial pressure reduction. The patients in treatment group underwent continuous lumbar drainage combined with cerebrospinal fluid replacement Treatment, the treatment of two groups to evaluate the effect of treatment. Results: The incidence of hydrocephalus (5%), the incidence of cerebral vasospasm (14.40%) in the treatment group was significantly lower than that in the control group (12%) and the incidence of cerebral vasospasm (48.32%) (P < 0.05 or P <0.01). The clinical neurological deficit score and daily living ability score improved significantly in the treatment group, with significant difference (P <0.05 or P <0.01). Conclusions: Lumbar drainage combined with cerebrospinal fluid replacement for the treatment of SAH can accelerate the clearance of bloody cerebrospinal fluid, reduce the stimulation of active substances in the blood, reduce the incidence of complications, improve the survival rate and improve the prognosis.