The Clinical Observation On The Treatment Of CVS Which The Because Of TSAH With Lumbar Drainage Of Cerebrospinal Fluid And Lateral Fissure Cistern External Drainage

Objective:To investigate therapeutic effect of lumbar drainage of cerebrospinal fluid and remaining a tube in lateral fissure cistern in saving the CVS, improve the Cerebral ischemia and Cerebral hypoxia in the patient of tSAH with Moderate or severe craniocerebral injury. Provide a reasonable and effective basis for the Operation methods and clinical therapeutics. To improve the therapeutic activity of Grassroots hospital in moderate and severe craniocerebral injury complicated with subarachnoid hemorrhage-induced cerebral Vasospasm,to decrease the patient deaths and improve outcomes.Methods:The 108 patient with scores of 3-12 on GCS who were admitted to our deparment from match.2005 to match.2011 were analyzed retrospectively.we dividea the 108 patient into three proups in random.there was no Significant differences in the age,sexual distinction and the conditions.the 36 patients as one group(the treatment),Were suffered to lateral fissure cistern external drainage and to lumbar drainage of cerebrospinal fluid(CSF) within 24 hours that after craniotomy;the 36 patients as one group(the NO.1 observation),were suffered to lumbar drainage of cerebrospinal fluid(CSF),the another 36 patients as one group(the NO.2 observation),were suffered to opened lateral fissure.To compared the Vm of the middle cerebral artery that were measured by TCD,Changes of intracranial pressure and the time that the number of red blood cells were lowered to 10×106/L.Postoperative follow-up of 6 months,evaluate Prognosis of the patient under GOS scoring.There is no obvious exceptions in spedialist treatment differences in three groups.Results:1.The Vm of MCA that after craniotomy's main point time in three groups (cm/s) (x±s)。The treament group was slower than the othertwo in the Vm of the MCA, And within the observation period average VM is in a relatively low level and no obvious ups and downs, significant different (P<0.05)。2. The average of the ICP that after craniotomy's main point time in three groups mmH2o) (x±s)。The change of the ICP at the same point of the time,, The treament group was lower than the other two's,And during the observation period are in the normal intracranial pressure level, significant different (P<0.05). 2.3The time that Negative microscopic examination of red blood cells in cerebrospinal fluid (d) (x±s):The average time of the treatment group Average negative microscopic examination of red blood cells in cerebrospinal fluid time significantly reduced than the other groups, significant different (P<0.05)2.4Postoperative follow-up of 6 months,evaluate Prognosis of the patient under GOS scoring (n) (x±s):The prognosis good rates of the treatment group was80.5%(29/36), which of the NO.1 Observation was 52.7%(19/36),the NO.2 Observation was 63.8%(23/36), there was significant different in the treatment to the other two's. (P<0.05).2.5 Three groups of patients and there is no drainage of excessive intracranial hypotension and cerebral hernia caused by crisis and the emergence of intracranial infection.Conclusion1,The bloody cerebrospinal fluid was removes quickly by lumbar drainage of cerebrospinal fluid and lateral fissure cistern external drainage, and it gived effective prevention for CVS.2,The ICP was lowed obviously by lumbar drainage of cerebrospinal fluid and lateral fissure cistern external drainage,and Improved brain blood circulation of the postoperative patients with severe cerebral injury.3,The mortality and disability rate can be lowed obviously by lumbar drainage of cerebrospinal fluid and lateral fissure cistern external drainage,for its relatively simple operation,,the methods were worth offering to primary hospitals,As well as the occurrence of intracranial infection.