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目的探讨持续腰大池脊液引流结合药物治疗脑动脉瘤性蛛网膜下腔出血(SAH)的临床疗效。方法 61例蛛脑动脉瘤性SAH患者随机分为观察组(31例)和对照组(30例)。对照组采用持续腰大池脊液引流治疗,治疗组采用持续腰大池脊液引流结合药物治疗。在术后第1、3、7、14d取脑脊液测定内皮素(ET)的含量,治疗14d后评价近期临床疗效。结果观察组无1例死亡,对照组死亡1例,死亡率为3.33%;观察组近期疗效总有效率为90.3%,显著高于对照组(80.0%),两组相比较差异有统计学意义(P<0.05);观察组脑脊液ET浓度变化较小,对照组第3d时脑脊液ET浓度就明显上升,第7d上升最明显,第10d后略有下降,但明显高于观察组同期脑脊液中ET浓度,两组相比较差异有统计学意义(P<0.05)。结论持续腰大池脊液引流结合药物治疗脑动脉瘤性SAH能有效抵制患者脑脊液ET的产生,治疗效果好,值得临床推广使用。
Objective To investigate the clinical efficacy of continuous lumbar drainage and drainage of drugs in the treatment of cerebral aneurysm subarachnoid hemorrhage (SAH). Methods Sixty-one patients with SAH were randomly divided into observation group (31 cases) and control group (30 cases). The control group was treated with continuous lumbar drainage of the spinal fluid, and the treatment group was treated with continuous lumbar drainage of the spinal fluid and drug therapy. The levels of endothelin (ET) in cerebrospinal fluid were measured on the 1st, 3rd, 7th and 14th day after operation, and the clinical effect was evaluated after 14 days. Results There was no death in the observation group, 1 death in the control group and 3.33% mortality rate. The total effective rate in the observation group was 90.3%, significantly higher than that in the control group (80.0%), the difference was statistically significant (P <0.05). The concentration of ET in cerebrospinal fluid of the observation group changed little in the observation group. The concentration of ET in the cerebrospinal fluid in the control group increased obviously on the 3d, increased most significantly on the 7th day and decreased slightly on the 10th day, Concentration, the difference between the two groups was statistically significant (P <0.05). Conclusions Continuous lumbar drainage with spinal drainage combined with drug treatment of cerebral aneurysm SAH can effectively inhibit the production of cerebrospinal fluid in patients with ET, the treatment effect is good, worthy of clinical promotion and use.