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目的探讨脑脊液置换联合地塞米松鞘内注射对蛛网膜下腔出血(SAH)的疗效。方法将确诊蛛网膜下腔出血的患者56例,随机划分治疗组(28例)和对照组(28例),治疗组在常规治疗基础上采取脑脊液置换术联合地塞米松鞘内注射治疗,对照组仅进行常规治疗,比较两组患者脑血管痉挛与脑积水发生率及病情转归。结果治疗组经过治疗,头痛、脑膜刺激征在短期内(4.78±2.56)d均明显好转,治愈好转率(85.7%)高于对照组(60.7%),且治疗期间缩短,治疗组和对照组脑血管痉挛发生率分别为10.2%、35.7%(P<0.05),治疗组和对照组脑积水发生率分别为7.1%、28.6%(P<0.05)。结论脑脊液置换联合鞘内地塞米松注射治疗组优于对照组,能迅速缓解临床症状,降低脑血管痉挛及脑积水发生率,减少并发症的发生。
Objective To investigate the effect of cerebrospinal fluid replacement combined with dexamethasone intrathecal injection on subarachnoid hemorrhage (SAH). Methods Fifty-six patients with confirmed subarachnoid hemorrhage were randomly divided into treatment group (n = 28) and control group (n = 28). The treatment group received cerebrospinal fluid replacement combined with dexamethasone intrathecal injection on the basis of routine treatment. Group only conventional treatment, compared two groups of patients with cerebral vasospasm and hydrocephalus incidence and prognosis. Results After treatment, headache and meningeal irritation in the treatment group were significantly improved in a short period of time (4.78 ± 2.56) d, the improvement rate of cure was 85.7% (60.7%), and the treatment period was shortened. The treatment group and the control group The incidence of cerebral vasospasm was 10.2% and 35.7%, respectively (P <0.05). The incidences of hydrocephalus in the treatment group and control group were 7.1% and 28.6%, respectively (P <0.05). Conclusion Cerebrospinal fluid replacement combined with intrathecal dexamethasone injection is superior to the control group, which can quickly relieve clinical symptoms, reduce the incidence of cerebral vasospasm and hydrocephalus and reduce the incidence of complications.