摘要
目的探讨SAH引起的局限性脑缺血和脑梗死的发病机制及其与发病年龄、发生SAH后就诊间隔时间的关系,为临床选择治疗方案提供帮助。方法对51例SAH患者,均做CT扫描和腰穿证实。经治疗后4d￣15d复查CT,部分病例行增强扫描。结果51例患者经治疗后有22例(22/51)患者平扫可见颅内小片状密度减低区,分布于额、颞、顶、枕各叶,增强后见强化征象。此外,随着患者年龄增大,发生SAH后就诊间隔时间的延长,脑内局限性缺血和梗死灶明显增多,患者的疗效明显降低。结论①局限性脑缺血和脑梗死作为蛛网膜下腔出血的常见并发症,主要发病机制是脑动脉痉挛。②患者脑池内出血越多,年龄越大,发生SAH后就诊间隔时间越长,此并发症发生率越高、对患者的预后影响越大。③CT扫描为首选的检查方法。
Objective To study the etiopathogenesis of regional cerebral ischemia and infarction induced by spontaneous subarachnoid hemorrhage （SAH） as well as their relationship with the ages and interval time from onset to hospitalization.Methods We reviewed and analyzed 51 cases of SAH confirmed by lumbar puncture and CT scan.Some of these cases were performed with contrasted CT scan 4-15 days after treatment.Results Small patchy hypodensity were found to scatter in the brain on plain CT scan in 22 cases （22/51）after treatment.And enhancement could also be showed on contrasted CT images. Futhermore, in both older cases and longer interval time cases, more lesions of regional cerebral ischemia and infarction were showed obviously, and poor therapeutic effect occurred easily.Conclusion （1）Regional cerebral ischemia and infarction were the common complications of SAH and the cardinal cause was cerebral arterial spasm. （2）The more the patient＇s brain pond internal bleeding , the older the patient and the longer the interval time, the higher the incidence rate and the more impact on prognosis for such complications. （3）CT was the first choice of checkup.
出处
《基层医学论坛》
2008年第19期632-633,共2页
The Medical Forum
关键词
蛛网膜下腔出血
计算机断层扫描
脑缺血
脑梗死
脑动脉痉挛
Subarachnoid hemorrhage Computer Tomography Cerebral ischemia Cerebral infarction Cerebral arterial spasm
