动脉瘤性与非动脉瘤性蛛网膜下腔出血的比较

Comparison between Aneuriysmal and Nonaneurysmal Subarachnoid Hemorrhage

目的探讨动脉瘤性和非动脉瘤性蛛网膜下腔出血(SAH)的诊断、治疗和预后的差异。方法对同期发现的非动脉瘤性SAH16例与动脉瘤性SAH117例患者的临床表现、入院时意识状况、HuntandHess分级以及头颅CT扫描、并发症及预后进行比较和分析。结果非动脉瘤性SAH与非动脉瘤性SAH相比,前者临床症状轻,无局灶性神经体征,16例中仅有2例出现意识障碍(12.5%,2/16),93.75%(15/16)患者HuntandHess分级为Ⅰ、Ⅱ级,Franz量化为(7.2+3.2)分。结论非动脉瘤性SAH,尤其是非动脉瘤性中脑周围SAH是一种特殊类型的出血模式,临床过程轻微,并发症少,预后良好。

Objective To explore the similarties and differences of the diagnosis, the treatment and the prognosis between nonaneurysmal subarachnoid hemorrhage （na-SAH） and aneurysmal subarachnoid hemorrhage （a-SAH）. Methods We compared the clinical manifestations, consciousness on admission, Hunt and Hess grade, CT scan features, complications and prognosis of 16 patients with na-SAH with 117 patients with a-SAH. Results In 16 patients with na-SAH, the clinical symptoms were not more serious than those in 117 patients with a-SAH, and na-SAH there was not focal nervous signs. In 16 patients with na-SAH there was loss of consciousness during hemorrhage in 2 （12.5%）, Hunt and Hess grading was grades Ⅰ - Ⅱ in 15 （93.75%） and Franz criticizing was （7.2＋3.2） points. Conclusion The na-SAH, especially perimesencephalic na-SAH, was a special type of SAH with a characteristic bleeding pattern, fewer complications and a better prognosis as compared to a-SAH.