蛛网膜下腔出血36例临床分析

Clinical research of 36 cases of subarachnoid hemorrhage

关键词:  蛛网膜下腔出血  脑疝  出血

Key words:  subarachnoid hemorrhage  cerebral hernia  hemorrhage

摘要:

［目的］探讨自发性蛛网膜下腔出血的临床表现、诊断及治疗。［方法］对自发性蛛网膜下腔出血36例的临床资料、脑脊液、头颅CT及脑血管造影进行分析。［结果］本组自发性蛛网膜下腔出血典型病例为31例(占86.1%)，而不典型病例为5例(占13.9%)；出血病因在中老年患者主要是脑动脉硬化，而青年人主要为脑动静脉畸形；死因主要是脑水肿、脑疝、再出血、肺部感染、上消化道出血等。［结论］对表现不典型的蛛网膜下腔出血，可及早行头颅CT及脑脊液检查确诊；病因检查以脑血管造影为优；治疗以减轻脑水肿，降低颅内压为主，并全面兼顾治疗，以促进恢复，降低死率。

Abstract:

［Objective］Discuss the clinical manifestation,diagnosis and treatment of spontaneous subarachnoid hemorrhage.［Method］Analyse the clinical data, cerebrospinal fluid,cerebral CT,and cerebral angiography of 36 cases of spontaneous subarachnoid hemorrhage.［Result］In the 36 cases,31 cases(86.1%) were typical,and 5 cases(13.9%) were atypical;in middle aged and senile patients,the main cause of hemorrhage was cerebral arteriosclerosis,in youth patients,the main cause of hemorrhage was arteriovenous malformation of brain;the causes of death are cerebral edema,cerebral hernia,re-hemorrhage, pulmonary infection,and hemorrhage of upper digestive tract,etc.［Conclusion］To atypical subarachnoid hemorrhage,we should practice cerebral CT and cerebrospinal fluid examination to confirm diagnosis as early as we can;cerebral angiography is the best method in etiological examination; in treatment,we should alleviate the cerebral edema,reduce the intracranial pressure, and treat systematically,to promote recovery,and reduce the fatality rate.