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动脉瘤性蛛网膜下腔出血的治疗

Authors
Robert J Singer, MD
Christopher S Ogilvy, MD
Guy Rordorf, MD
Section Editor
Jose Biller, MD, FACP, FAAN, FAHA
Deputy Editor
Janet L Wilterdink, MD
Translators
王伊龙, 主任医师，教授

引言

蛛网膜下腔出血(subarachnoid hemorrhage, SAH)常是一个灾难性事件。大约有10%的患者送达医院前已经死亡，而仅1/3的患者在经过治疗后会有“良好的结果”[1]。该恶性疾病治疗方面的进展已加入至其医疗装备中。一项研究报道的1971-2002年SAH的病死率下降，以及另一项研究报道的在1981-1986年和2002-2008年这两个时间段SAH病死率的下降，可能反映了在这些时期内SAH治疗方法的改善。

SAH的治疗将总结在此。该疾病的其他方面将单独讨论。(参见“动脉瘤性蛛网膜下腔出血的病因、临床表现和诊断”和“未破颅内动脉瘤”)

预后

动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage, ASAH)并发症发生率和死亡率高。该病在最初30日内死亡率接近50%，很大程度上归因于最初的出血和复发性出血[2]。

SAH短期预后的最重要预测因素包括[3-5]：

  • 入院时患者的意识水平和神经功能分级
  • 患者年龄(呈负相关)
  • 首次头部计算机断层(computed tomography, CT)扫描的出血量(呈负相关)

                                  

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Literature review current through: 2017-06 . | This topic last updated: 2014-10-07.
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