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目的探讨外伤性蛛网膜下腔出血时早期行脑脊液置换的临床疗效及安全性。方法回顾性分析2006年10月—2010年6月收住云南省昭通市第一人民医院重症医学科的外伤性蛛网膜下腔出血患者116例,随机分为两组,其中治疗组60例、对照组56例。两组病例均给予常规治疗,有手术指征者手术治疗,其中治疗组在入院后48h内给予腰穿脑脊液置换术,置换液为生理盐水和地塞米松注射液。每天或隔天置换1次,共计3~7次。结果治疗组患者GCS评分较对照组明显增加,治疗组住ICU时间明显缩短,并发症的发生率及死亡率明显低于对照组。结论外伤性蛛网膜下腔出血早期脑脊液置换疗效好,风险及不良反应小,并发症少,且操作简单安全,值得临床推广应用。
Objective To investigate the clinical efficacy and safety of early cerebrospinal fluid replacement in traumatic subarachnoid hemorrhage. Methods A retrospective analysis of 116 patients with traumatic subarachnoid hemorrhage admitted to the First People’s Hospital of Zhaotong City, Yunnan Province from October 2006 to June 2010 was randomly divided into two groups, including 60 in the treatment group, Control group of 56 cases. Two groups of patients were given conventional treatment, surgical indications were surgical treatment, in which the treatment group within 48h after admission to give lumbar puncture and cerebrospinal fluid replacement, replacement fluid for saline and dexamethasone injection. Replace every day or next 1, a total of 3 to 7 times. Results The GCS score of the treatment group was significantly higher than that of the control group. The ICU time of the treatment group was significantly shortened, and the complication rate and mortality rate were significantly lower than those of the control group. Conclusion Early traumatic subarachnoid hemorrhage replacement of cerebrospinal fluid early treatment effect, risk and adverse reactions, fewer complications, and the operation is simple and safe, worthy of clinical application.