蛛网膜下腔出血后迟发脑血管痉挛的临床特点(1)
 |
| 第1页 |
参见附件(2034KB，2页)。
[摘要] 目的：探讨蛛网膜下腔出血后迟发脑血管痉挛的临床特点。方法：回顾性分析我院2005年2月~2009年3月收治的蛛网膜下腔出血后迟发脑血管痉挛患者60例临床资料。结果：DCVS在SAH后3~4 d发生，于第2周达高峰，至少持续40 d。SAH并DCVS的主要病因是颅内动脉瘤破裂，与动脉瘤的部位及大小无明显关系，SAH后基底池内的高密度影与DCVS的发生密切相关，DCVS的发生与年龄、性别无关。结论：基底池中凝血块的存在是产生DCVS的直接原因。DCVS的发生于第2周达高峰，尼莫地平持续静脉推注能显著降低SAH的死亡率。
[关键词] 蛛网膜下腔出血 脑血管痉挛 尼莫地平
[中图分类号] R743.35[文献标识码]A [文章编号]1673-7210(2011)02(c)-053-02
Clinical characteristics of the delayed cerebral vasospasm after subarachnoid hemorrhage
WANG Lijing, CUI Yanling, SUN Limin, ZHAO Rongbing, GAO Xiaoyan
(Daqing Oil Field General Hospital,Daqing 163000, China)
[Abstract] Objective: To explore the clinical features of delayed subarachnoid hemorrhage cerebral vasospasm. Methods:A retrospective method was used to compare 60 cases of subarachnoid hemorrhage with delayed cerebral vasospasm in our hospital from February 2005 to March 2009. Results: DCVS occurred 3-4 days after the SAH, reached a peak in the second week, lasted at least 40 days.SAH complicated with DCVS was the main cause of the intracranial aneurysm rupture,and there was no significant relationship with the location and size of the aneurysm. The high density substrate pool of the SAH was closely related with the DCVS, the occurrence of the DCVS has no relationship with the patiens' age and sex.Conclusion: The sludged blood of the base pool is the direct cause to produce clot DCVS. The peak of the DCVS occurres in the second week, continuous intravenous injection of nimodipine can significantly reduce the mortality rate of SAH.
[Key words] Subarachnoid hemorrhage; Cerebral vasospasm; Cimodipine
迟发脑血管痉挛(Delayed cerebral vasospasm，DCVS)是蛛网膜下腔出血(SAH)的主要并发症，指颅底动脉的一支或多支血管平滑肌的持续收缩，或血管损伤引起管腔形态学的变化，在动脉造影时表现出血管管腔狭窄，发生率高达30%~90%，是患者致死、致残的主要原因之一[1]。目前诊治仍存在困难。为了探索其临床规律，本文对2005年2月~2009年3月收治的蛛网膜下腔出血后迟发脑血管痉挛患者60例临床资料进行了回顾性研究，归纳如下。
1资料与方法
1.1 一般资料
我院2005年2月~2009年3月收治的蛛网膜下腔出血后脑血管痉挛患者60例，全部病例符合全国第四届脑血管学术会议制定的诊断标准[2]，经颅脑CT及腰穿证实。其中，男32例，女28例；年龄最小21岁，最大78岁，平均年龄48.7岁。患者起病至入院时间2 h~4 d。既往史：伴高血压病25例(41.67%)，冠心病11例(18.33%)，有间断性头痛者6例(10.00%)。
1.2 治疗方法
所有患者均绝对卧床休息，给予脱水降颅内压、控制血压、抗纤溶、止血、镇静、止痛及通便治疗，并积极预防并发症，维持水、电解质平衡及支持疗法。所有患者入院2 h内开始用微量泵持续静脉推注尼莫地平针剂，初始速度0.5~1.0 mg/h，2 h后如无血压下降等不良反应，加大剂量至1 ......
您现在查看是摘要介绍页，详见PDF附件(2034KB，2页)。