脑脊液引流联合法舒地尔治疗颅脑外伤后脑血管痉挛疗效观察

目的 观察脑脊液引流联合法舒地尔治疗颅脑外伤后脑血管痉挛的疗效.方法 63例颅脑外伤出现脑血管痉挛患者随机分成对照组（n=31）和联合治疗组（n=32）,在止血、降颅压、预防感染以及补充水电解质等治疗基础上,对照组给予法舒地尔30 mg加入生理盐水100 mL中静滴,30 min,2次/d,连用14 d;治疗组给予法舒地尔联合脑脊液引流,患者取侧卧位,取L3～L4间隙为穿刺点,引流量控制在200～300 mL/d,一般尽可能保持匀速引流,置管5～14 d.对比2组患者脑血管痉挛和脑梗死的发生率.结果 联合治疗组血管痉挛的发生率显著低于对照组,差异有统计学意义（χ2=8.11,P＆lt;0.01）;联合治疗组脑梗死的发生率显著低于对照组,差异有统计学意义（χ2=16.72,P＆lt;0.001）.结论 联合应用脑脊液引流与法舒地尔可明显降低颅脑外伤患者脑血管痉挛与脑梗死的发生率,值得临床推广应用.

The study about efficacy of drainage of cerebrospinal fluid combined with fasudil on the cerebral vasospasm after craniocerebral trauma

Objective To study the efficacy of drainage of cerebrospinal fluid combined with fasudil on the cerebrovascular spasm after craniocerebral trauma. Methods 63 patients with the cerebrovascular spasm of traumatic brain injury were divided into 2 groups, control group（n= 31） and treatment group（n： 32）. In the foundational treatment of stop bleeding, reducing in- tracranial pressure, prevention of infection as well as water and electrolyte supplement, the control group were given fasudil , and the treatment group received fasudil combined with cerebrospinal fluid drainage . The incidence rate of cerebral vasospasm and cerebral infarction were detected by radiographic and clinical observation. Results In treatment group, the incidence rate of cerebral vasospasm was significantly lower than that in the control group （X2 = 8.11, P〈0.01）, and the incidence rate of cere bral infarction was also significantly lower than that in the control group （X2 = 16.72, P〈0. 001）. Conclusion CSF drainage combined with fasudil can significantly reduce incidence of cerebral vasospasm and cerebral infarction in patients with craniocerebral trauma and it is worthy of further study in clinic .