急性蛛网膜下腔出血的CT血管造影及其护理

CT angiography and nursing of acute subarachnoid hemorrhage

目的:探讨CT血管造影在急性蛛网膜下出血(ASH)患者的应用及其护理。方法:选取2009年1月-2011年12月ASH患者32例,记录患者发病时间与进行CT检查及ASH诊断时间,ASH诊断时间至证实为血管瘤病变的时间以及诊断方法(CTA或DSA),血管瘤诊断至确定性治疗时间,延迟治疗(>24小时)原因,主要的护理方法。结果:研究期内共有32例患者因ASH住院,其中28例经CT诊断,4例经腰穿诊断。其中男20例,女12例,年龄(52.4±7.2)岁。发病至入院时间0.5~20.1(4.5±3.4)小时,发病至CT检查时间2.5~22.3(8.4±3.5)小时,ASH至血管瘤诊断时间0.25~212(22.35±12.45)小时。血管瘤延迟治疗的原因主要为未能及时进行CTA或DSA检查、患者早期情况恶化而不能进行进一步检查,证实为血管瘤至采取确定性治疗时间0.75~240(42.6±23.5)小时。结论:早期行CTA检查可使多数ASH患者确定病因,血管瘤延迟进行确定性治疗的主要原因为未能及时进行CTA或DSA检查、患者早期病情恶化无法进一步检查确诊。为了降低死亡率及改善患者预后,颅内动脉瘤一旦诊断明确,即应采取积极的治疗和护理措施。

Objective:To explore the application and nursing of CT angiography in acute subarachnoid hemorrhage.Methods:32 cases of ASH were selected from January 2009 to December 2011.We recorded the time of onset of patients,the time of with CT examination and ASH diagnosis,the time from ASH diagnosi to confirmed for hemangioma lesions and diagnostic methods(CTA or DSA),the time from confirmed for vascular tumor to definitive treatment time,the reason of delayed treatment(more than 24 hours) and the main methods of nursing.Results:In the study period,32 cases were hospitalized for ASAH.Among them,28 cases were diagnosed by CT,and 4 cases were diagnosed through lumbar puncture.20 cases were male,and 12 cases were female.The average age was 52.4±7.2 years old.The onset to admission time was 0.5 to 20.1(4.5±3.4)hours.Onset to CT examination time was 2.5 to 22.3(8.4±3.5)hours.ASH to hemangioma diagnosis time was 0.25 to 212(22.35±12.45)hours.The causes of delayed treatment of hemangioma were failed to CTA or DSA check in time and no further examination because of the deterioration of patients condition.Confirmed hemangiomas to taking definitive treatment time was 0.75 to 240(42.6±23.5)hours.Conclusion:The early CTA examination can make most patients with SAH to determine the cause.The causes of delayed treatment of hemangioma were failed to CTA or DSA check in time and no further examination because of the deterioration of patients condition.In order to reduce the mortality and improve the prognosis of patients with intracranial aneurysms,once be diagnosed,the patients should be given active treatment and care.