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目的:考察SAH的发病原理、诊治要点,为今后该病的临床诊治提供参考指导。方法:对我院2012年6月~2013年4月间收治64例SAH患者的诊治过程进行分析。诊断:主要依据患者临床症状、颅脑CT检查和腰椎穿刺脑脊液检查结果进行确诊。治疗:所有患者确诊为SAH后绝对卧床休息;立即进行止血(预防再出血)、降低颅内压、保护脑细胞、预防血管痉挛的药物及脑室引流手术治疗。结果:64例患者中,痊愈33例(33/64);好转15例(15/64);无效或恶化10例(10/64);死亡6例(7/64)。其中3例患者为再出血死亡;2例患者为呼吸衰竭合并肾衰死亡;1例患者为脑梗死死亡。结论:SAH的诊治一定要综合考虑患者临床症状以及相关医学检查,一旦确诊后要立即进行对症治疗,加强病情监控,才能有效提高临床治疗效果,降低致残致死率。
Objective: To investigate the pathogenesis of SAH, diagnosis and treatment of key points for the clinical diagnosis and treatment of the disease provide a reference guide. Methods: The diagnosis and treatment of 64 cases of SAH patients in our hospital from June 2012 to April 2013 were analyzed. Diagnosis: mainly based on clinical symptoms of patients, brain CT examination and lumbar puncture cerebrospinal fluid examination results confirmed. Treatment: All patients were diagnosed as SAH absolute bed rest; immediately stop bleeding (to prevent rebleeding), reduce intracranial pressure, protect brain cells, prevent vasospasm drugs and ventricular drainage surgery. Results: Of the 64 patients, 33 (33/64) were cured, 15 (15/64) improved, 10 (10/64) ineffective or worsening, and 6 (7/64) deaths. Three of them died of rebleeding; two died of respiratory failure with renal failure; one died of cerebral infarction. Conclusion: The diagnosis and treatment of SAH must be comprehensively considering the clinical symptoms and related medical examinations. Once diagnosed, the symptomatic treatment should be conducted immediately and the condition monitoring should be strengthened so as to effectively improve the clinical therapeutic effect and reduce the lethal mortality rate.