自发性蛛网膜下腔出血的临床研究

Clinical Study of the Spontaneous Subarachnoid Hemorrhage

目的:探讨自发性蛛网膜下腔出血的病因及相关治疗的临床价值。材料与方法:对32例自发性蛛网膜下腔出血的患者进行CT和DSA和腰椎穿刺检查明确诊断,探讨相关病因并进行积极治疗。结果:32例自发性蛛网膜下腔出血患者中24例造影阳性,其中颅内动脉瘤破裂21例,(椎动脉夹层动脉瘤破裂2例),AVM 2例,DAVF 1例。21例动脉瘤破裂患者中栓塞13例,2例术中破裂,其中1例抢救成功,1例死亡,在6～12个月随访5例行血管造影,瘤体栓塞完全,载瘤动脉通畅。结论:自发性网膜下腔出血病例行脑血管造影,早期发现动脉瘤等危险因素并给予相关治疗是预防再出血的有效措施。

Purpose： To investigate the etiology and treatmem of clinical value of the spontaneous subarachnoid hemorrhage. Materials and Methods： 32 cases of patients with subarachnoid hemorrhage diagnosed by CT, DSA and lumbar puncture, discussion related etiology and active treatment. Results： 8 of 32 patients were negative and 24 were positive. Among 32 cases, 21 ruptured intracranial aneurysms （2 ruptured the dissecting aneurysm of vertebral artery）, 2 cases of AVM, 1 cases of DAVF. In 21 cases of ruptured intracranial aneurysms, 19 cases were embolismed. 2 cases were ruptured during operation, and one rescued successful, the other died. In 6 - 12 months of follow- up 5 routine angiography, embolization aneurysm completely, the parent artery patency. Conclusion： Spontaneous subarachnoid hemorrhage to carry out brain angiography commonly, early discovery the risk factor for example aneurysm and to give treatment would be a utility measure for prevent rehaemorrhagia.