论文部分内容阅读
目的分析蛛网膜下腔出血(SAH)的临床表现﹑CT征象﹑病因机理及临床应用,评价CT诊断SAH的意义。方法分析我院74例有完整资料的经腰穿检查、生化检查及CT证实的SAH,并进行归纳和总结。结果自发性SAH35例,外伤性SAH39例。男46例,女28例。临床表现为突发剧烈头痛或尖叫61例,频繁呕吐47例,一过性意识障碍31例,脑膜刺激征36例,偏瘫11例,抽搐8例,紫绀5例,病理反射7例,眼底出血3例。CT表现为:1)局限于侧脑裂内条带状或小片状高密度影。2)局限于脑池内铸型高密度影。3)局限于脑纵裂、脑沟内线状、条带状高密度影。4)广泛分布于脑基底池、脑裂及脑沟内的高密度影。5)不典型脑裂或脑沟内线片状稍高密度影。6)出血的CT密度一般在35～60HU,并常合并其他表现。结论 CT诊断SAH是完全可靠的,一般无需做腰穿检查。16排以上螺旋CT机及双源CT检查后进行3D重建后处理可发现SAH的病因,为临床治疗提供客观科学依据。
Objective To analyze the clinical manifestations, CT signs, etiological mechanism and clinical application of subarachnoid hemorrhage (SAH) and evaluate the significance of CT diagnosis of SAH. Methods 74 cases of our hospital with complete information through the lumbar puncture, biochemical tests and CT confirmed SAH, and summarized and summarized. Results 35 cases of spontaneous SAH, traumatic SAH 39 cases. 46 males and 28 females. Clinical manifestations of sudden severe headache or screaming sudden 61 cases, 47 cases of frequent vomiting, transient disturbance of consciousness in 31 cases, meningeal irritation in 36 cases, 11 cases of hemiplegia, convulsions in 8 cases, 5 cases of cyanosis, pathological reflex in 7 cases, fundus Bleeding in 3 cases. CT showed: 1) confined to the lateral slit in the brain or small pieces of high-density film. 2) confined to the brain pool of high-density cast film. 3) confined to the brain longitudinal crack, brain groove linear, strip-shaped high-density shadow. 4) Widely distributed in the brain basal cistern, brain crack and brain groove in the high-density shadow. 5) atypical brain crack or atrioventricular groove slightly high density film. 6) Bleeding CT density is generally 35 ~ 60HU, and often combined with other performance. Conclusion CT diagnosis of SAH is completely reliable, generally do not need to do lumbar puncture. More than 16 rows of spiral CT machine and dual-source CT examination after 3D reconstruction post-treatment can be found in the etiology of SAH, for clinical treatment to provide an objective scientific basis.