自发性蛛网膜下腔出血不同时间脑血管造影的临床对照研究  

The contrasting Study of DSA imaging of different time in spontaneous subarachnoid hemorrhage

作　　者：张新萍[1] 耿加贵[1] 陆寅[1] 刘军[1] 苗素云[1] 赵君[1] 

机构地区：[1]泰安市中心医院,山东泰安271000

出　　处：《泰山医学院学报》2006年第2期120-122,共3页Journal of Taishan Medical College

摘　　要：目的探讨蛛网膜下腔出血脑血管造影的最佳时间及早期病因诊断，以减少并发症，选择最佳治疗方案。方法对269例不同时间脑血管造影的SAH患者进行回顾性对照研究，据发病时间分为A、B、C、D共4组。对其病因、造影时间，可能出现的并发症及治疗方案进行分析。结果脑血管造影异常者186例．占69．1%。B组（发病1～3天）DSA阳性率与A组差异有统计学意义（P〈0．05）；B组外科治疗例数与A组和D组差异有统计学意义（P〈0.05），B组再出血、脑血管痉挛发生率明显低于其他三组。结论发病1～3天脑血管DSA检查再有利于颅内血管病变的及时诊断与治疗，减少SAH再出血、脑血管痉挛等并发症的发生。Objective： To explore the early etiologic diagnosis, the best optimal time of angigraphy and the therapeutic method of spontaneous subarachnoid hemorrhage. Methods： Retrospective analysis was made about the clinical data of 269 patients with spontaneous subarachnoid hemorrhage, who were had digital subtraction angiography （DSA）. They were divided into four groups： A, B, C and D according to the time of angiography, The angiography were done within 1 day , 143 days, 447 days and 8414 days. The causes, the time of angiography, probably complications and the choices of therapies were analyzed and compared. Result： DSA showed that 186 cases suffered from aneurysms. The main causes of SAH were aneurysms（ 52. 0 %）, cerebrovascular malformation（ 10. 8 %）, arteritis（ 3. 3%）, and Moyamoya（ 1.9%）. The positive rate in B group was significantly different from that in group A （P 〈0. 05） ,and not different from that of group C and group D （P 〉0. 05） ; Those treated by surgery in B group were 76. 1%, which was significantly different from groups A and D but not different with group C. Group B was significantly different from other three groups in recurrence of hemorrhage and cerebrovascular spasm. Conclusion： The cerebral aneurysms are the most common causes for SAH, Encephalon angiography within 143 days can im prove the probability in finding out cranial vasculopathy, which provides more effective therapeutic method in time and reduce such complications as recurrence of hemorrhage,crebrovascular spasm and hydrocephalus.

关 键 词：自发性蛛网膜下腔出血 数字减影脑血管造影 时间选择 并发症 

分 类 号：R743.3[医药卫生—神经病学与精神病学]