外伤性蛛网膜下腔出血预后的临床行为学评估

Assessment study of behavior on the prognosis of posttraumatic SAH

目的评价颅脑外伤后蛛网膜下腔出血（ＳＡＨ）影响预后的各种因素。方法分析１１８例颅脑外伤后ＳＡＨ病人的年龄、格拉斯哥评分（ＧＣＳ）、脑干反射、生命体征和腰穿资料和预后的关系。结果外伤性ＳＡＨ病人的预后比无ＳＡＨ病人的预后明显差。ＧＣＳ低于３分，脑干反射消失绝大多数显示预后不良，生命体征严重紊乱、严重意识障碍、腰穿脑脊液红细胞数大于１万／ｍｌ和颅内压力（ＩＣＰ）持续增高的病人预后较差；因此以上因素与预后有密切关系。结论这些检查简单易行，评估指标明确，对外伤性ＳＡＨ的诊治及预后判断有价值。

bjective To evaluate factors of posttraumatic subarachnoid hemorrhage(SAH) affecting on the prognosis.Methods 118 patients with subarachnoid hemorrhage (SAH) after brain injuries were reported by authors.The relations between the age、Glasgow coma scale(GCS)、reflex of stem、vital signs、and CSF were analysed.Results The prognosis of patients with posttraumatic SAH were obviously poorer than those without SHA.When patients' GCS were less than 3 and/of their brain stem reflex did not exist,their prognoses were poor.The patients with severe disorder of vital signs and consciousness and more than 10,000 erythrocytes in 1ml CSF and continuous high ICP had very poor prognosis. The studies indicated their relations were very close.Conclusions These examinations are simple and valuable to evaluating the prognosis and to guiding diagnosis and treatments.