动脉瘤性蛛网膜下腔出血后脑血管痉挛的防治研究

Research of Prevention and Treatment of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

对于动脉瘤性蛛网膜下腔出血，预后影响因素多种多样，包括年龄、基础疾病、发病时Fisher分级和Hunt-Hess分级以及围术期用药，开颅夹闭动脉瘤手术时机的选择、动脉瘤特点、手术方式、术中对载瘤动脉的阻断时间、术中是否发生动脉瘤破裂、控制性低血压技术，麻醉用药，术后管理等相关因素，术后并发症尤以脑梗死多见且危害大。本文通过研究自发性蛛网膜下腔出血后发生延迟性脑血管痉挛或延迟性脑缺血（DCVS）的相关发病机制，总结目前对于自发性蛛网膜下腔出血导致的脑血管痉挛的治疗现状及进展，通过预防动脉瘤破裂出血后缺血性并发症的发生，达到改善脑动脉瘤破裂后发生脑梗死这一并发症的目的。

Objectiv： The prognostic factors of aneurysmal subarachnoid hemorrhage are versatile, such as age, underlying diseases, the classification of Fisher and Hunt Hess and perioperative medication options, Selection of operative timing for cerebral angiography and eraniotomy, Aneurysm characteristics, Surgical approach, Blocking time of the responsible arteries, Whether intraoperative aneurysm rupture, Controlled hypotension, Anesthesia medication, Postoperative management, etc. Cerebral infarction are the most common and harmful postoperative complications. Through the study of the underlying pathogenesis of delayed cerebral vasospasm following spontaneous subarachnoid hemorrhage, to summary of Current Status and Progress in the Treatment of Cerebral Vasospasm Caused by Spontaneous Subarachnoid Hemorrhage. By preventing aneurysm rupture after the onset of ischemic complications, aim to improving the cerebral aneurysm rupture occurred after the complication of cerebral infarction purposes.