蛛网膜下腔出血急性期CT及临床因素与继发脑损害的关系

摘要

Objective 　To search the relative factors of cerebral damage, rebleeding, delayed cerebral ischaemia(DCI) and hydrocephalus after subarachnoid haemorrhage (SAH) by CT scans and clinical findings in acute phase. Methods　To analyse the relationship between cerebral damage after SAH and clinical findings: CT scans resulte, age, sex, blood pressure, hyponatraemia, therapeutic methods. Results　Cerebral damage were related to the pattern of distritution of SAH on brain CT and hyponatraemia. The high attack rate of rebleeding and DCI is related to presence of blood in the surface of brain, collection of blood in the ventricle, saccula aneurysms or cerebral arteriovenous malformation (AVM) (P＜0.01). Conclusions　To forecast of cerebral damage after SAH by study of CT scans showing and clinical findings have clincal significance. According to these findings, we may take some therapeutics to prevent the cerebral damage after SAH.%目的探讨蛛网膜下腔出血(SAH)急性期CT表现及临床因素与继发脑损害(再出血、迟发性脑梗死、脑积水)的相关因素，为防治提供参考依据。方法分析SAH在颅内的分布情况、年龄、性别、血压、血钠、脑血管造影及治疗方法的选择等与SAH继发脑损害的关系。结果继发脑损害均与CT显示积血阳性、分布区域不同和低钠血症有关，其中再出血和脑梗死以脑表面有积血块或脑室有血者发生率较高(均P＜0.01)，预后也较差。脑血管有病变或CT显示SAH者发生再出血或脑梗死较多。结论 SAH急性期CT及临床相关因素对其继发脑损害的预测有一定临床意义，并可据此进行防治。