目的　探讨蛛网膜下腔出血 (SAH)脑脊液置换治疗的效果及其与出血量和出血部位的关系。方法　回顾性分析 5 4例行脑脊液置换治疗SAH患者的临床资料。结果　疗效与出血量和出血部位有关 ,18例经置换后病情加重的患者其出血量大 ,出血聚集在脑干周围、脑室及脑沟表面形成血块。结论　对于出血量大、出血聚集在脑干周围、脑室及脑沟表面形成血块者 ,应慎行脑脊液置换。 Objective To investigate the effect of subarachnoid hemorrhage (SAH) on cerebrospinal fluid replacement and its relationship with bleeding and bleeding sites. Methods The clinical data of 54 patients with SAH treated by cerebrospinal fluid replacement were retrospectively analyzed. Results Efficacy and bleeding and bleeding sites, 18 patients exacerbated by exacerbation of patients with large bleeding, bleeding gathered around the brain stem, brain and sulci surface of the formation of blood clots. Conclusion For bleeding, bleeding concentrated around the brain stem, brain and sulci surface clot formation who should be cautious cerebrospinal fluid replacement.