【摘要】 目的 :观察经侧脑室短期重复应用重组链激酶 (r SK)并引流脑脊液 ,对预防脑动脉瘤破裂蛛网膜下隙出血 (SAH)后迟发性脑血管痉挛 (DCV)的效果。方法 :14例脑动脉瘤破裂Fisher 3级患者 ,于 72h内行瘤颈夹闭或瘤体介入栓塞术 ,以及侧脑室外引流后 ,分为治疗组和对照组 ,各 7例。治疗组经侧脑室注入r SK 5mg·d-1,连续 2～ 3d。术后出现迟发性神经功能损害者诊断为DCV ;术后 1～ 3个月以GOS评估预后。结果 :治疗组术后SAH血凝块 3～ 4d消失 ,无DCV发生 ,GOS均为 5分。对照组术后 4～ 10d血凝块消失 ,3例无DCV发生 ,GOS为 5分 ;4例DCV者 ,2例GOS为 4分、3分和 1分各 1例。结论 :经侧脑室短期重复应用r SK ,对防治SAH后DCV有较好的疗效。更多还原

【Abstract】 Aim:Preventing patients with aneurysm from delayed cerebral vasospasm (DCV) after subarachnoid hemorrhage (SAH) was evaluated by repeated injections of recombinant streptokinase (r-SK)into lateral venticle in short period coupled with drainge of cerebral spinal fluid (CSF).Methods:14 patients classified as Fisher Grade 3 were treated with venticulostomy and surgery for aneurysm clipping or Guglielmi detachable coils (GDC) within 72 hours after aneurysm rupture. 7 patients of them were treated with r-SK (5mg everyday)by injection into lateral ventricle,and other 7 as control.Symptomatic DCV was diagnosed as the onset of delayed neurological deteriotation.Functional prognosis was evaluated 1 month after SAH or discharge according to the Glasgow Outcome Scale.Results:The clot was cleared completely within 3 to 4 days after surgery or GDC for patients with r-SK (dosage 10～15mg) who had good recovery;while within 4 to 10 days for control patients,3 had good recovery,2 were moderately disabled,1 was severe disabled and another died.Conclusion:Repeated injection of r-SK into lateral ventricle in short period coupled with drainage of CSF was a good method for preventing patients with aneurysm from DCV after SAH.更多还原