Abstract：【Objective】To investigate the clinical effect of cerebrospinal fluid replacement in the treatment of subarachnoid hemorrhage in children.【Methods】 A total of 98 children with subarachnoid hemorrhage treated in our hospital from June 2019 to January 2021 was randomly divided into observation group and control group, with 49 cases in each group. The children in the control group were given routine treatment, and the children in the observation group were treated with cerebrospinal fluid replacement on the basis of routine treatment. The recovery of consciousness, clinical neurological deficit, complications and ability of daily living were compared between the two groups. 【Results】 The recovery time of neck stiffness and consciousness in the observation group were lower than those in the control group. The proportion of cerebrospinal fluid returning to normal after one week of treatment was higher than that in the control group (P<0.05). The proportion of children with nerve defect in the observation group was 6.12% (3/49), which was significantly lower than 20.41% (10/49) in the control group(χ2=4.346,P=0.037＜0.05).The incidence of complications in the observation group was 8.16% (4/49), which was lower than 22.45% (11/49) in the control group(χ2=3.857,P=0.049＜0.05).After treatment, the scores of physiological function, physiological function, physical pain, general health and energy in the two groups were higher than those before treatment, and the scores in the observation group were higher than those in the control group (P<0.05). 【Conclusion】 The clinical effect of cerebrospinal fluid replacement in the treatment of subarachnoid hemorrhage in children is significant, which can effectively improve the nerve defect and reduce the incidence of complications.
张津维, 吴水华, 苏君, 陈朝晖. 脑脊液置换治疗小儿蛛网膜下腔出血的临床效果分析[J]. 医学临床研究, 2021, 38(10): 1537-1539.
ZHANG Jin-wei, WU Shui-hua, SU Jun, et al. Clinical Effect of Cerebrospinal Fluid Replacement in the Treatment of Subarachnoid Hemorrhage in Children. JOURNAL OF CLINICAL RESEARCH, 2021, 38(10): 1537-1539.
[1] 宋跃,钱素云,李艳,等.尼莫地平预防儿童蛛网膜下腔出血后脑血管痉挛的效与安全性研究[J].中华儿科杂志,2019,57(5):338-343. [2] 沈杰,车雄宇,高亚宏,等.前列地尔联合尼莫地平对动脉瘤性蛛网膜下腔出血后脑血管痉挛患者血管内皮功能及炎症因子水平的影响[J].现代生物医学进展,2019,19(5):69-73. [3] HEFFREN J, MCINTOSH A M, REITER P D. Nimodipine for the prevention of cerebral vasospasm after subarachnoid hemorrhage in 12 children[J].Pediatr Neurol,2015,52(3):356-360. [4] 任剑,沈光建,张云东.影响动脉瘤性蛛网膜下腔出血1年预后的相关因素分析[J].重庆医学,2020,49(22):3791-3795. [5] BLACKBURN S L, GRANDE A W, SWISHER C B, et al. Prospective trial of cerebrospinal fluid filtration after aneurysmal subarachnoid hemorrhage via lumbar catheter (PILLAR)[J].Stroke,2019,50(9):2558-2561. [6] 谢昭太,陆四方,蔡叶盛.鞘内注射地塞米松联合脑脊液置换术治疗蛛网膜下腔出血疗效观察[J].海南医学,2018,29(14):1963-1965. [7] 向迅捷,徐才邦,孙留中,等.采用脑室冲洗进行脑脊液置换在脑脊液异常的脑积水患者脑室腹腔分流术中的应用效果[J].广西医学,2020,42(5):559-561. [8] VAN LIEVERLOO G G A. Corticosteroids in chronic inflammatory demyelinating polyneuropathy: A retrospective, multicentre study, comparing efficacy and safety of daily prednisolone, pulsed dexamethasone, and pulsed intravenous methylprednisolone[J].J Neurol,2018,265(9):2052-2059. [9] 孙力,徐才邦,向迅捷,等.脑室冲洗与常规脑脊液置换在脑脊液蛋白增高脑积水中的比较研究[J].国际神经病学神经外科学杂志,2019,46(6):65-68.
2021, Vol. 38 
