脑脊液置换联合尼莫地平地塞米松鞘内注射治疗蛛网膜下腔出血疗效分析.docVIP

脑脊液置换联合尼莫地平地塞米松鞘内注射治疗蛛网膜下腔出血疗效分析 　　【摘要】 目的 研究脑脊液置换联合尼莫地平、地塞米松鞘内注射治疗蛛网膜下腔出血(SAH)的治疗作用。方法 将127例SAH患者随机分为试验组和对照组;对照组应用镇静、止痛、药物(EACA、尼莫地平片)等常规治疗方法,试验组在常规治疗的基础上,应用腰穿脑脊液置换和鞘内注射尼莫地平、地塞米松。结果 SAH的头痛症状以及脑积水、蛛网膜粘连、脑血管痉挛等主要并发症的发生率、死亡率,试验组明显少于对照组,经统计学处理,有统计学差异。结论 脑脊液置换联合尼莫地平、地塞米松鞘内注射治疗蛛网膜下腔出血,可明显降低SAH主要并发症的发生率和死亡率,其方法简便,效果可靠,有非常实用的临床价值。 　　【关键词】蛛网膜下腔出血;脑脊液置换;尼莫地平;地塞米松;鞘内注射;疗效 　　 　　Analysis of Curative Effect about Combining Exchange of Cerebrospinal Fluid with Intrathecal Injection in Nimodipine and Dexamethasohe(D.X.M)for Subarachnoid Hemorrhage 　　 　　XIANG Jian-guo,LU Wei.The First People Hospital of PingJiang,HuNan 414500, China 　　 　　【Abstract】 Objective To examine the therapeutic effect about combining exchange of cerebrospinal fluid with intrathecal injection in Nimodipine and D.X.M for subarachnoid hemorrhage. Methods One hundred and twenty-seven patients were divided randomly into two groups:control group and test group. Both groups were given routine treatment, such as mitigation, acesodyne and medicament, for example, EACA and Tab Nimodipine, but the test group was cured by intrathecal injection of exchange of cerebrospinal fluid and intrathecal injection of nimodipine and D.X.M of treatment additionally. Results The incidence of occurrence and mor- 　　? 　　作者单位:410400湖南省平江县第一人民医院 　　 　　tality of headache, bydrocephalus and Cerebral vasospasm in test group werw significantly lower than those in control group, and the difference had statistic value. Conclusion Combining exchange of cerebrospinal fluid with intathecal injection in Nimodipine and D.X.M is a good way on the treatment of SAH which can be widely used in Clinical. 　　【Key words】 Subarachnoid hemorrhage;Evhange of cerebrospinal fluid; Nimodipine and D.X.M; Intrathecal injection; Curative effect. 　　 　　蛛网膜下腔出血(subarachnoid hemorrhage, SAH)又称为原发性蛛网膜下腔出血,是最常见的脑血管意外之一;其急性期并发症主要有脑血管痉挛、急性交通性脑积水、再出血等,严重威胁患者的生命和致残后降低患者的生存质量。对临床上怀疑有蛛网膜下腔出血的患者均应进行CT、腰穿、脑血管造影等辅助检查,以求尽早明确诊断,确定出血来源。但在一些基层医院,由于不能做脑血管造影,故不能在发病早期进行动脉瘤