Meditronic引流管在治疗动脉瘤性蛛网膜下腔出血中应用探究.docVIP

Meditronic引流管在治疗动脉瘤性蛛网膜下腔出血中应用探究【摘要】 目的 探讨持续腰大池脑脊液引流在动脉瘤性蛛网膜下腔出血治疗中的疗效。方法 对42例SAH患者实施持续腰大池脑脊液引流治疗,并与对照组39例SAH患者每日行常规腰穿进行比较。两组均在动脉瘤开颅夹闭24内进行腰椎穿刺术。治疗组腰大池内置入美国Meditronic公司体外引流管行持续性脑脊液外引流;对照组每日行常规腰穿术,缓慢释放脑脊液,一般每日释液在10-70 ml,平均50ml。两组在脑积水发生率和血性脑脊液清除速率等方面进行比较。结果 治疗组术后3-8月随访结果治疗组脑积水发生率明显低于对照组;治疗组血性脑脊液清除速率也明显比对照组快。结论 持续腰大池脑脊液引流是治疗SAH的一种更安全、有效的方法,能显著降低SAH患者的继发性脑损害,降低SAH患者脑积水发生率,减轻脑血管痉挛,促进脑功能恢复。 【关键词】动脉瘤性蛛网膜下腔出血;脑脊液;引流;治疗; 【中图分类号】R739.4 【文献标识码】 B 【文章编号】1005-0515(2010)007-017-02 Study on Effect of Continuous Lumbar Drainage of Cerebrospinal Fluid in Patients With Aneurysmal Subarachnoid Hemorrhage Luo Xiangying1,,Fang Jiashen2 Duan JiXin1, Feng Guang1 (1. Changsha traditiongal hospital(8th hospital);2. Xiangya hospital ,central south university) Abstract:ObjectiveTo observe the effect of continuous lumbar drainage of cerebrospinal fluid(CLDCF) on the Aneurysmal subarachnoid hemorrhage through a meditronic tube.MethodsComparison of the treatment results of 42 patients with SAH treated through CLDCF and 39 patients as the control group treated with routine daily lumbar puncture (LP) was performed. Both groups were treated through LP within 24h. The control group was let out hemorrhagic cerebrospinal fluid (CSF) through LP daily. The daily amount and the average amount of CSF were10-70ml and 50ml respectively.Results The incidence rate of post-traumatic hydrocephalus and the flow rate of hemorrhagic cerebrospinol fluid (CSF) showed significant differences between the two groups in the 3-8 month follow-up.ConclusionCompared with the traditional treatment, CLDCF is more safe and effective in treatment of traumatic subarachnoid hemorrhage and it can accelerate the recovery of disease. Key words: Aneurysmal subarachnoid hemorrhage; Cerebrospinal fluid; Drainage; Treatment; 动脉瘤性蛛网膜下腔出血(subarachnoid hemorrhage,SAH)是神经外科的危重急症之一[1]。动脉瘤性SAH占自发性SAH的80%左右,是自发性SAH的主要原因[2]。动脉瘤性SAH术后最严重和最主要的并发症为脑血管痉挛及脑积水。结合2007年9月-2010年3月长沙市中医医院以及中南大学湘雅医院神经外科对42例颅内动脉瘤术后患者实施了动脉瘤夹闭术后24