蛛网膜下腔出血36例临床分析

Clinical research of 36 cases of subarachnoid hemorrhage

[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。

[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 arte- riosclerosis,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 di- gestive tract,etc.[Conclusion]To atypical subarachnoid hemorrhage,we should practice cerebral CT and cere- brospinal fluid examination to confirm diagnosis as early as we can;cerebral angiography is the best method in e- tiological examination;in treatment,we should alleviate the cerebral edema,reduce the intracranial pressure,and treat systematically,to promote recovery,and reduce the fatality rate.