《中国康复理论与实践》

《中国康复理论与实践》 ›› 2004, Vol. 10 ›› Issue (02): 103-105.

• 临床研究 • 上一篇    下一篇

炎性抑制与蛛网膜下腔出血后头痛的关系

段东印   

  1. 新乡医学院第二附属医院 河南新乡市 453000
  • 收稿日期:2003-11-12 出版日期:2004-02-25 发布日期:2004-02-25

Relation of inflammatory inhibition and headache after subarachnoid hemorrhage

DUAN Dong-yin   

  1. The Second Affiliated Hospital of Xinxiang Medical College, Xinxiang 453002, Henan, China
  • Received:2003-11-12 Published:2004-02-25 Online:2004-02-25

PDF (PC)

被引次数

20

摘要： 目的探讨蛛网膜下腔出血(SAH)后头痛的发生是否与蛛网膜下腔炎性改变有关,同时观察地塞米松的免疫抑制作用对头痛的疗效。方法将80例意识清醒、能主诉头痛的SAH患者随机分为4组:单独应用甘露醇治疗组(甘露醇组)、在应用甘露醇基础上行脑脊液置换组(置换组)、地塞米松鞘内注射组(鞘内组)和静脉注射组(静脉组),观察各组患者的止痛效果。结果各组的总有效率分别为:甘露醇组27.27%、置换组66.67%、鞘内组92.36%、静脉组30.00%,鞘内组疗效与其他组疗效的差异有显著性意义,且头痛缓解时间显著延长(P<0.01)。结论发生质变的血性脑脊液引起的蛛网膜下腔广泛免疫炎性反应是导致头痛的重要原因,鞘内注射地塞米松治疗SAH后头痛效果显著。

关键词: 蛛网膜下腔出血, 头痛, 脑脊液置换, 地塞米松

Abstract: ObjectiveTo explore pathogenesis of headache after subarachnoid hemorrhage (SAH) whether related with immune inflammatory reaction in subarachnoid and observe the effect of immunosuppressive action of dexamethasone on headache.Methods80 patients who was consciousness and complained headache after SAH were randomly divided into four groups, treated only with mannitol, mannitol plus cerebrospinal fluid (CSF) replacement, intrathecal and vein injection with dexamethasone. Effects of four groups were observed.ResultsEfficiencies of four groups were respectively the mannitol group 27.27%, the permutation group 66.67%, the intrathecal group 92.36% and the vein group 30.00%. There was a significantly difference between the intrathecal group and other three groups, and the time of headache remission for intrathecal group was also longer than that of other three groups (P<0.01).ConclusionThe wide immune inflammatory responses in subarachnoid induced by degenerative and hemic CSF is likely main cause of headache after SAH and intrathecal injection with dexamethasone has an obviously effect.

Key words: subarachnoid hemorrhage (SAH), headache, cerebrospinal fluid replacement, dexamethasone