基层医院自发性蛛网膜下腔出血的早期救治特点  

Features of Early Treatment of Spontaneous Subarachnoid Hemorrhage in Primary Hospitals

作　　者：林斌[1] 何俊[1] 魏平波[1] 

机构地区：[1]绵竹市人民医院神经外科,四川618200

出　　处：《社区医学杂志》2013年第12期22-23,共2页Journal Of Community Medicine

摘　　要：目的探讨自发性蛛网膜下腔出血患者在基层医院的早期救治特点。方法回顾性分析2012年2月至2013年2月收治的35例急性自发性蛛网膜下腔出血患者的临床资料。结果 29例Hunt-Hess分级Ⅰ～Ⅲ级患者中早期转诊27例,转诊率93.10%,所有转诊患者转诊途中病情无加重。1例患者在拟转诊过程中因再出血死亡。1例拒绝转诊,药物保守治疗1周后发生再出血。Ⅳ～Ⅴ级6例,早期转诊0例,1例在保守治疗1周后病情好转予以转诊,非常规出院(放弃治疗或死亡)5例。结论对于Hunt-HessⅠ～Ⅲ级的SAH患者,基层医院的早期转诊率高,予以早期转诊是安全的,Ⅳ～Ⅴ级的重症患者预后不佳,大都非常规出院。Objective To explore the features of early treatment of spontaneous subarachnoid hemorrhage（SAH） in prima- ry hospitals. Methods The clinical data of 35 cases of spontaneous subarachnoid hemorrhage from February 2012 to Febru- ary 2013 were retrospectivdy analyzed. Results Of 29 patients with Hunt -Hess grade Ⅰ -Ⅲ, 27 received early referral and were stable, the rate of referral was 93.10%, no exacerbation occurred in the referral process; 1 died of rebleeding in referral planning; 1 refused referral and developed rebleeding after one - week conservative treatment. Of 6 patients with Hunt -Hess gradelV （ Ⅴ, none received early referral, 1 got improved after one -week conservative treatment and was re- ferred; 5 were discharged unconventionally （ discontinuance of treatment or death）. Conclusions For SAH patients of Hunt - Hess grade -Ⅲ, early referral has a high rate in primary hospitals and is often safety; for severe SAH patients of Hunt- Hess gradelV （ Ⅴ, they usually have poor prognoses and are discharged unconventionally.

关 键 词：蛛网膜下腔出血 早期救治 基层医院 早期转诊 病死率 致残率 

分 类 号：R743.35[医药卫生—神经病学与精神病学]