脑脊液置换术治疗蛛网膜下腔出血的临床效果分析
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摘要
目的探讨脑脊液置换术治疗蛛网膜下腔出血的临床效果。方法纳入我院神经外科2016年2月～2017年11月90例蛛网膜下腔出血患者以随机数字表法分组。对照组进行常规方法治疗,观察组行脑脊液置换术治疗。比较两组蛛网膜下腔出血治疗效果;头痛缓解时间、清除脑脊液血红蛋白时间;干预前后患者生存质量SF-36量表评分;并发症情况。结果观察组蛛网膜下腔出血治疗效果高于对照组,差异有统计学意义(P <0.05);观察组头痛缓解时间、清除脑脊液血红蛋白时间优于对照组,差异有统计学意义(P <0.05);干预前两组生存质量SF-36量表评分相近,差异无统计学意义(P> 0.05);干预后观察组生存质量SF-36量表评分优于对照组,差异有统计学意义(P <0.05)。观察组并发症少于对照组,差异有统计学意义(P <0.05)。结论蛛网膜下腔出血患者行脑脊液置换术的治疗及效果确切,可有效改善症状和生存质量,减少并发症的发生,加速症状消失,缩短疗程。
Objective To investigate the clinical effect of CSF substitution in the treatment of subarachnoid hemorrhage. Mehtods 90 patients with subarachnoid hemorrhage who admitted to neurosurgery department of Meizhou People's Hospital from February 2016 to November 2017 were divided into observation group and control group by number table method.The control group received regular method treatment,and the observation group received CSF substitution treatment.The therapeutic effects of subarachnoid hemorrhage,headache remission time,cerebrospinal fluid hemoglobin clearance time,quality of life SF-36 scale score and complications before and after intervention were compared between the two groups. Results The therapeutic effect of subarachnoid hemorrhage in the observation group was higher than that in the control group(P < 0.05).The time of headache relief and the clearance of cerebrospinal fluid hemoglobin in the observation group were better than those in the control group(P< 0.05).The scores of SF-36 were similar between the two groups before intervention(P > 0.05).The SF-36 scale score of the observation group was better than that of the control group after intervention, and the complications in the observation group were less than those in the control group(P < 0.05). Conclusion CSF substitution in the treatment of subarachnoid hemorrhage can effectively improve the symptoms and quality of life,reduce the occurrence of complications,accelerate the disappearance of symptoms and shorten the course of treatment.
Objective To investigate the clinical effect of CSF substitution in the treatment of subarachnoid hemorrhage. Mehtods 90 patients with subarachnoid hemorrhage who admitted to neurosurgery department of Meizhou People's Hospital from February 2016 to November 2017 were divided into observation group and control group by number table method.The control group received regular method treatment,and the observation group received CSF substitution treatment.The therapeutic effects of subarachnoid hemorrhage,headache remission time,cerebrospinal fluid hemoglobin clearance time,quality of life SF-36 scale score and complications before and after intervention were compared between the two groups. Results The therapeutic effect of subarachnoid hemorrhage in the observation group was higher than that in the control group(P < 0.05).The time of headache relief and the clearance of cerebrospinal fluid hemoglobin in the observation group were better than those in the control group(P< 0.05).The scores of SF-36 were similar between the two groups before intervention(P > 0.05).The SF-36 scale score of the observation group was better than that of the control group after intervention, and the complications in the observation group were less than those in the control group(P < 0.05). Conclusion CSF substitution in the treatment of subarachnoid hemorrhage can effectively improve the symptoms and quality of life,reduce the occurrence of complications,accelerate the disappearance of symptoms and shorten the course of treatment.
引文
[1]陈雪江.脑脊液置换术治疗蛛网膜下腔出血效果观察[J].医学综述,2015,21(9):1720-1721.
[2]Walcott,Brian P,Stapleton,et al.Diffuse patterns of nonaneurysmal subarachnoid hemorrhage originating from the basal cisterns have predictable vasospasm rates similar to aneurysmal subarachnoid hemorrhage[J].Journal of Stroke and Cerebrovascular Diseases:The official journal of National Stroke Association,2015,24(4):795-801.
[3]陈向林,胡扬真,毛振敏,等.尼莫地平灌注联合脑脊液置换术治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛的疗效分析[J].湖南中医药大学学报,2013,33(6):33-34,45.
[4]Wenz H.,al Mahdi,M.-M.,Ehrlich,G.et al.De Novo aneurysm of the anterior communicating artery presenting with subarachnoid hemorrhage 7 years after initial cryptogenic subarachnoid hemorrhage:A Case Report and Review of the Literature[J].Clinical Neuroradiology,2015,25(1):93-97.
[5]贾云飞.早期腰大池引流与腰穿脑脊液置换治疗创伤性蛛网膜下腔出血的疗效比较[J].现代中西医结合杂志,2014,23(4):405-407.
[6]Van Donkelaar,Carlina E.,Bakker,et al.Predictive factors for rebleeding after aneurysmal subarachnoid hemorrhage rebleeding aneurysmal subarachnoid hemorrhage study[J].Stroke:A Journal of Cerebral Circulation,2015,46(8):2100-2106.
[7]王云,程选飞,韩英,等.舒适护理在蛛网膜下腔出血患者脑脊液置换术围手术期的应用[J].贵阳中医学院学报,2013,35(2):247-248.
[8]杨新芳.脑脊液置换术治疗蛛网膜下腔出血的观察与护理[J].中国实用神经疾病杂志,2013,16(16):98-99.
[9]赵建凯.持续腰大池引流与腰椎穿刺脑脊液置换术治疗蛛网膜下腔出血迟发性血管痉挛的疗效观察[J].临床医药文献电子杂志,2016,3(14):2769-2769,2771.
[10]廖春俊,邓艳.地塞米松鞘内注射与单纯脑脊液置换治疗蛛网膜下腔出血的疗效分析[J].当代临床医刊,2016,29(5):2515.
[11]孟云,周宏斌,朱言亮,等.亚低温联合脑脊液置换对动脉瘤性蛛网膜下腔出血介入术后继发性脑血管痉挛及脑积水的影响[J].中西医结合心脑血管病杂志,2015,13(9):1148-1150.
[12]鲍兵,陈志颖,谈丹丹,等.腰椎穿刺脑脊液置换对动脉瘤性蛛网膜下腔出血患者血管内栓塞术后脑脊液核因子κB和转归的影响[J].国际脑血管病杂志,2017,25(2):140-144.
[13]党帅.腰大池置管引流脑脊液置换治疗蛛网膜下腔出血的并发症及处理[J].中国现代医学杂志,2017,27(16):104-107.
[14]程玮涛,王宁,陈文劲,等.腰池置管脑脊液持续外引流术与脑脊液置换术治疗重症蛛网膜下腔出血150例临床疗效对比[J].临床和实验医学杂志,2016,15(2):140-142.
[15]宿红伟.脑脊液置换术治疗蛛网膜下腔出血的临床疗效探讨[J].中外医疗,2015,34(25):12-14.
[2]Walcott,Brian P,Stapleton,et al.Diffuse patterns of nonaneurysmal subarachnoid hemorrhage originating from the basal cisterns have predictable vasospasm rates similar to aneurysmal subarachnoid hemorrhage[J].Journal of Stroke and Cerebrovascular Diseases:The official journal of National Stroke Association,2015,24(4):795-801.
[3]陈向林,胡扬真,毛振敏,等.尼莫地平灌注联合脑脊液置换术治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛的疗效分析[J].湖南中医药大学学报,2013,33(6):33-34,45.
[4]Wenz H.,al Mahdi,M.-M.,Ehrlich,G.et al.De Novo aneurysm of the anterior communicating artery presenting with subarachnoid hemorrhage 7 years after initial cryptogenic subarachnoid hemorrhage:A Case Report and Review of the Literature[J].Clinical Neuroradiology,2015,25(1):93-97.
[5]贾云飞.早期腰大池引流与腰穿脑脊液置换治疗创伤性蛛网膜下腔出血的疗效比较[J].现代中西医结合杂志,2014,23(4):405-407.
[6]Van Donkelaar,Carlina E.,Bakker,et al.Predictive factors for rebleeding after aneurysmal subarachnoid hemorrhage rebleeding aneurysmal subarachnoid hemorrhage study[J].Stroke:A Journal of Cerebral Circulation,2015,46(8):2100-2106.
[7]王云,程选飞,韩英,等.舒适护理在蛛网膜下腔出血患者脑脊液置换术围手术期的应用[J].贵阳中医学院学报,2013,35(2):247-248.
[8]杨新芳.脑脊液置换术治疗蛛网膜下腔出血的观察与护理[J].中国实用神经疾病杂志,2013,16(16):98-99.
[9]赵建凯.持续腰大池引流与腰椎穿刺脑脊液置换术治疗蛛网膜下腔出血迟发性血管痉挛的疗效观察[J].临床医药文献电子杂志,2016,3(14):2769-2769,2771.
[10]廖春俊,邓艳.地塞米松鞘内注射与单纯脑脊液置换治疗蛛网膜下腔出血的疗效分析[J].当代临床医刊,2016,29(5):2515.
[11]孟云,周宏斌,朱言亮,等.亚低温联合脑脊液置换对动脉瘤性蛛网膜下腔出血介入术后继发性脑血管痉挛及脑积水的影响[J].中西医结合心脑血管病杂志,2015,13(9):1148-1150.
[12]鲍兵,陈志颖,谈丹丹,等.腰椎穿刺脑脊液置换对动脉瘤性蛛网膜下腔出血患者血管内栓塞术后脑脊液核因子κB和转归的影响[J].国际脑血管病杂志,2017,25(2):140-144.
[13]党帅.腰大池置管引流脑脊液置换治疗蛛网膜下腔出血的并发症及处理[J].中国现代医学杂志,2017,27(16):104-107.
[14]程玮涛,王宁,陈文劲,等.腰池置管脑脊液持续外引流术与脑脊液置换术治疗重症蛛网膜下腔出血150例临床疗效对比[J].临床和实验医学杂志,2016,15(2):140-142.
[15]宿红伟.脑脊液置换术治疗蛛网膜下腔出血的临床疗效探讨[J].中外医疗,2015,34(25):12-14.
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