自发性蛛网膜下腔出血的脑血管造影时机的选择及其并发症的探讨

A study on time choice and complications of cerebral angiography of subarachnoid hemorrhage

目的分析自发性蛛网膜下腔出血（SAH）数字减影血管造影检查的结果，探讨有关脑血管造影时机的选择及其并发症的原因。方法对502例SAH患者经股动脉插管进行选择性全脑血管造影检查，对所有造影结果进行分析。结果总阳性率为74、7％（375／502），在发病后6h内、6-24h、25—72h、73h-14d、15d-1个月和1个月后检查阳性率分别为82．6％、72．9％、74．4％、76．4％、75％和77．3％。与造影有关的神经系统并发症共21例。结论造影时机并不影响对脑血管病变的检出率，但选择合适的造影时机、熟练操作和应用非离子型造影剂可降低造影并发症的发生。

Objective To study the time choice and causes of complications of cerebral angiography by retrospectively analyzing the clinical data of SAH patients underwent DSA. Methods Selective DSA was conducted in 502 patients with SAH. All DSA results were analyzed. Results Cerebral angiographis were performed in 6 groups （ 〈6h, 6h-24h, 25h-72h, 73h-14d, 15d-1m, 〉 1m） after SAH, and the rate of abnormal cases were 82. 6% , 72. 9% , 74. 4% , 76. 4% , 75% 和77. 3% respectively, total 74. 7% （375/502）. There were 21 cases who had neurological complications during or after DSA. Conclusions The time choice of cerebral angiography has no influence on the rate of abnormal findings in DSA. But the suitable time choice, good operation skill and application of non-ionic contrast agent can reduce the complications of DSA.