脑脊液置换术治疗蛛网膜下腔出血的随机对照试验

目的探讨脑脊液置换术治疗蛛网膜下腔出血的疗效及安全性.方法60例经头颅CT及腰穿确诊的蛛网膜下腔出血患者,由计算机产生随机数字,按单、双数随机分为两组.对照组30例接受常规治疗,治疗组30例在常规治疗的基础上行脑脊液置换术,比较两组的疗效及并发症发生情况.统计分析采用SPSS10.0软件.结果治疗组头痛持续时间、脑血管痉挛、脑积水发生率均少于对照组,其差异有统计学意义(P<0.05);再出血发生率与对照组比较,其差异无统计学意义(P=1.000);两组疗效比较,差异有统计学意义RR3.00,95%CI(1.014,8.880),P=0.044],治疗组优于对照组.治疗组术中、术后均未发生脑疝形成、颅内感染和低颅压性头痛等并发症.结论脑脊液置换术 常规治疗治疗蛛网膜下腔出血优于单纯常规治疗,且安全性良好.

Exchange of Cerebrospinal Fluid for Subarachnoid Hemorrhage: A Randomized Controlled Trial

Objective To explore the effectiveness and safety of exchange of cerebrospinal fluid in the treatment of subarachnoid hemorrhage (SAH).Methods Sixty SAH patients diagnosed by CT and lumbarpuncture were randomly assigned into a control group (n=30, received conventional treatment) and a treatment group (n=30, received exchange of cerebrospinal fluid plus conventional treatment). The main complications and effectiveness between the two groups were compared. SPSS 10.0 was used for statistical analysis. Results Compared with the control group, complications of persistent headache (P=0.002 and 0.007 respectively), cerebral vasospasm (P=0.028) and hydrocephalus (P=0.038) were fewer in the treatment group. No significant difference in the incidence of rehaemorrhagia was found between the two groups (P=1.000). Better effectiveness was observed in the treatment group (RR 3.00, 95%CI 1.014 to 8.880, P=0.044). Conclusions Exchange of cerebrospinal fluid plus conventional treatment is more effective than conventional treatment alone in the treatment of SAH.