Comparison of effects of continuous lumbar cistern drainage and cerebrospinal fluid replacement in treatment of patients with spontaneous subarachnoid hemorrhage
Objective:To compare effects of continuous lumbar cistern drainage and cerebrospinal fluid replacement in treatment of patients with spontaneous subarachnoid hemorrhage.Methods:A prospective study was conducted on 60 patients with spontaneous subarachnoid hemorrhage admitted to the hospital from January 2022 to October 2023.According to the random number table method,they were divided into study group and control group,30 cases in each group.The control group was treated with cerebrospinal fluid replacement,while the study group was treated with continuous lumbar cistern drainage.The levels of clinical related indexes,the intracranial pressure before and after the surgery,the good prognosis rate,the incidence of complications within 1 month after the surgery,and the postoperative neurological function indexes[serum netrin-1,matrix metalloproteinase-9(MMP-9)]levels were compared between the two groups.Results:The hematoma clearance rate of the study group was higher than that of the control group;the headache disappearance time,the intracranial pressure recovery time and the cerebrospinal fluid clearance time were shorter than those of the control group;and the differences were statistically significant(P<0.05).At 5 and 7 days after the surgery,the intracranial pressure levels of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).The good prognosis rate of the study group was 93.33%(28/30),which was higher than 73.33%(22/30)of the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the study group was 3.33%(1/30),which was lower than 26.67%(8/30)in the control group,and the difference was statistically significant(P<0.05).Further,1 month after the surgery,the levels of MMP-9 in the two groups were lower than those 5 days after the surgery,and that in the study group was lower than that in the control group;the levels of netrin-1 in both groups were higher than those 5 days after the surgery,and that in the study group was higher than that in the control group;and the differences were statistically significant(P<0.05).Conclusions:Continuous lumbar cistern drainage in the treatment of the patients with spontaneous subarachnoid hemorrhage can improve the good prognosis rate,improve the levels of clinical related indexes and neurological function indexes,and reduce the intracranial pressure and the incidence of complications.Moreover,it is superior to cerebrospinal fluid replacement.