摘要
目的探讨不等量脑脊液置换并鞘内注射尿激酶治疗蛛网膜下腔出血(SAH)的临床疗效。方法219例经头颅CT及腰穿确诊的蛛网膜下腔出血患者随机分为不等量脑脊液置换并鞘内注射尿激酶组(治疗组,n=116)和不等量脑脊液置换组(对照组,n=113)。比较两组患者主要临床症状、体征恢复情况,主要并发症发生情况,治疗前后神经功能缺损评分及疗效。结果治疗组头痛基本缓解,颈项强直基本消失,意识障碍明显改善,均明显优于对照组(P<0.01),治疗组脑积水、脑血管痉挛并发症发生率明显少于对照组(P<0.01),神经功能缺损评分比对照组明显减少(P<0.01);再出血发生率与对照组比较无明显差异(P>0.05);总有效率明显高于对照组(P<0.01)。结论不等量脑脊液置换并鞘内注射尿激酶可明显提高临床疗效,减少并发症发生率,同时不会增加再出血风险。
Objective To explore the clinical eurative effect of combination of different amount of eerebrospinal fluid replacement with urokinase injection for treatment of subaraehnoid hemorrhage （SAH）. Methods Two hundred and nineteen eases of SAH diagnosed by computer tomography and lumbar puncture were randomly divided into two groups： 116 patients in the treatment group were performed with combination of different amount of cerebrospinal fluid replacement with intrathecal injection of urokinase, 113 patients in the control group were treated with different amount of cerebrospinal fluid replacement. The principal clinical symptom, signs recovery and main complications in two groups were compared. Neurologic impairment scoring and curative effects were performed in two groups pre - and post - treatment. Results Headache was essentially relieved, neck rigidity almost disappeared, conscious disturbance was improved obviously in treatment group, which were obviously better than those in control group（P 〈 0.01 ）. incidence of hydrocephalus and cerebral anglo spasm in treatment group were obviously lower those in control group（P〈 0.01 ）, Score of neurologic impairment was lower compared to the control group （P〈0.01）. Incidence of rehaemorrhagia was no significant difference compared to the control group. And total effective rate in treatment group was obviously higher than that in control group（P〈0.01 ）. Conclusion Combination of different amount of eerebrospinal fluid replacement with intrathecal injection of urokinase for treatment of SAH, which can obviously increase clinical efficacy , decrease incidence of complications and won＇ t increase risk of rehemorrhagia.
出处
《新乡医学院学报》
CAS
2006年第3期272-274,共3页
Journal of Xinxiang Medical University
关键词
蛛网膜下腔出血
不等量脑脊液置换
尿激酶
subarachnoid hemorrhage
cerebrospinal fluid replacement
urokinase
