Clinical observation of small volume replacement of cerebrospinal fluid in the treatment of acute subarachnoid hemorrhage

Objective:To observe the feasibility and effectiveness of small volume of cerebrospinal fluid replacement in the treatment of acute subarachnoid hemorrhage.Method:Sixty patients with acute spontaneous subarachnoid hemorrhage in our EICU from August 2010-August 2011 were selected.All patients were confirmed by CT,MRI and cerebral angiography with no hematoma、cerebral hemorrhage、aneurysm、arteriovenous malformations and cavernous hemangiomas et al,which required surgical or interventional treatment,and they were randomly divided into two groups:the conventional therapy group(30 cases) and cerebrospinal fluid replacement group(30 cases).Patients in the conventional therapy group were given the traditional treatment and a simple release of cerebrospinal fluid.Patients in the cerebrospinal fluid replacement group were given replacement of hemorrhagic CSF through lumbar puncture with equivalent volume of 0.9% saline for seven times.The cerebrospinal fluid was sent to make cytology examination.Result:The clinical symptoms of cerebrospinal fluid replacement group improved significantly compared with conventional treatment group after treatment.The difference of the total efficiency between replacement group and conventional treatment group was statistically significant(P0.05).The difference of the red blood cell number and white blood cell number before the fourth lumbar puncture in CSF replacement group compared with the conventional treatment group was statistically significant(P0.05),the difference was statistically significant(P0.05)in the seventh cerebrospinal fluid.Conclusion:Several times of small capacity fluid replacement may be effective in improving the cerebrospinal fluid circulation,relieving headaches,vomiting,meningeal irritation and other symptoms.This method is simple、minimally invasive 、safe、effective and appropriate to carry out in the primary hospitals in China.