3D-CTA检查在基层医院诊断自发性蛛网膜下腔出血患者的临床实用性分析

Clinical Value of Computerized Tomography Angiography in the Diagnosis and Treatment of Spontaneous Subarachnoid Hemorrhage

目的探讨3D—CTA在基层医院诊断自发性蛛网膜下腔出血（SAH）患者的临床实用性。方法通过3D—CTA检查自发性SAH患者36例，结合DSA，开颅手术、介入栓塞术、保守治疗结果证实3D—CTA检查结果及临床实用性。结果通过3D-CTA技术检查SAH患者36例，4例为非动脉瘤性SAH。32例动脉瘤阳性患者共发现34个动脉瘤。13例行介入栓塞治疗。5例开颅动脉瘤夹闭。6例放弃手术，要求保守治疗。8例要求转上级医疗中心。结论3D-CTA较DSA具备快速、便捷、微创、安全、敏感性高、家属认同度高、基层临床医生易于掌握和开展等优点，在基层医院具有很强的临床实用性。患者可在第一时间得到准确合理的救治。

Objective To evaluate the clinical value of computerized tomography angiography（CTA） in the diagnosis and treatment of spontaneous subarachnoid hemorrhage（SAH） in the basic level hospital.Method 36 cases with SAH were examined by CTA and looked for cerebral aneurysms,then confirmed by digital subtraction angiography（DSA）,surgical clipping,interventional embolization therapy, conservative treatment. Results Among the 36 patients with SAH examined by CTA,there were 32 patients with 34 cerebral aneurysms. 13 patients performed by DSA and interventional embolization therapy,5 patients confirmed by surgical clipping operation,6 patients asked for conservative treatment,8 patients went to superior medical department.Conclusion Three dimensional CT angiography has the following characteristics：quick, short time consuming,without trauma,relatively safe,excellent sensitivity, the sensitive of diagnosis aneurysms in SAH was better.CTA can provide useful information for therapy approaches in the basic level hospital and can be regarded as the first choice for the diagnosis and treatment of ruptured intracranial aneurysms,useful information for planning microsurgical approaches.