绿色通道救治蛛网膜下腔出血126例的效果评价  

Evaluation of Emergency Medical Treatment Green Passage Treatment of Subarachnoid Hemorrhage among 126 Cases

作　　者：李勇[1] 张俊玲[2] 王馥梅[2] 张乐国[2] 朱翠敏[3] 

机构地区：[1]河北省沧州市中心医院急诊科 [2]河北省沧州市中心医院神经内二科 [3]河北省沧州市中心医院儿科,沧州061001

出　　处：《中国医药导刊》2011年第3期407-408,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨绿色通道对蛛网膜下腔出血病因诊断及治疗方案选择的意义。方法:回顾性分析2007年1月～2009年12月实施绿色通道对126例蛛网膜下腔出血患者行急症CTA或DSA检查,确定病因,快速多学科会诊,制定治疗方案,并在治疗后3个月行日常生活能力Barthel指数测评。结果:126例蛛网膜下腔出血发现动脉癌106例,其中行栓堵治疗55例,手术夹闭38例,保守治疗13例;治疗中及治疗后发生血管痉挛11例,再出血6例,脑积水12例,死亡6例。动静脉畸形8例,其中行栓堵治疗2例,手术治疗2例,保守治疗4例;治疗中及治疗后发生血管痉挛1例,再出血1例,脑积水1例,死亡1例。CTA或DSA未见明显异常者12例,均采取保守治疗。治疗后3个月日常生活能力Barthel指数测评明显改善。结论:医院多学科协作,开通绿色通道,可以在最短时间内明确蛛网膜下腔出血的原因,为病因治疗提供依据,可降低急性期死亡率,改善预后。Objective：Discussion about significance of emergency medical treatment green passage to cause of disease diagnosis and therapeutic schedule choice of subarachnoid hemorrhage.Methods：Review analysis of one hundred and twenty six patients of subarachnoid hemorrhage who examined emergency CTA or DSA from 2007.1-2009.12 for determining cause,working out therapeutic schedule,requesting multiple disciplines consultation and evaluating brothel after three months.Results：55 embolism,38 operation close,13 expectant treatment of 106 aneurysm, ll angiospasm,6 Recurrence of hemorrhage,12 hydrocephalus,6 death under or after treatment.2 embolism,2 operation close,4 expectant treatment of 8 arterior＊venous malformation,l angiospasm, lrecurrence of hemorrhage,1 hydrocephalus, l death under or after treatment.12 patients＇ DSA were normal who carried out expectant treatment.Brothel were improved after three months. Conclusion：Multi- disciplinary cooperations and emergency medical treatment green passage may be clear about cause of subarachnoid hemorrhage in the shortest time,afford provides of treatment,cut the death rate and improve the prognosis.

关 键 词：蛛网膜下腔出血 绿色通道 病因治疗 

分 类 号：R743.35[医药卫生—神经病学与精神病学]