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目的:通过对急性SAH超早期(48小时内)行DSA检查,探讨其病因诊断价值及降低病死率的措施。方法:选择急性SAH住院病人100例,随机分为DSA和腰穿两组,各50例病人,均行脑CT和腰穿检查明确诊断。DSA组48小时内行DSA检查,依据不同DSA结果,采取外科手术或内科治疗两种方法。腰穿组仅作腰穿、脑CT检查以及传统的内科治疗方法。结果:DSA组病因诊断为脑动静脉畸形12例,手术治疗10例;脑动脉瘤16例,手术治疗10例;烟雾病6例,手术治疗2例;动脉炎3例;原因不明13例;共死亡6例,病死率8.3％。腰穿组共死亡10例,病死率35.7％。两组比较有显著差异(P<0.05)。结论:对于急性SAH患者超早期行DSA检查,可及时明确病因诊断,从而针对不同病因采取不同治疗措施,显著降低病死率,缩短病程。该方法有较大的临床价值和推广前景。
Objective: To investigate the etiological diagnosis value and the measures to reduce the mortality of patients with acute SAH through ultrasonography (48 hours) DSA. Methods: One hundred patients with acute SAH inpatients were randomly divided into DSA group and lumbar group. All 50 patients were diagnosed by brain CT and lumbar puncture. DSA group within 48 hours DSA examination, depending on the results of different DSA, surgical or medical treatment to take two methods. Waist wear group only for lumbar puncture, brain CT examination and the traditional medical treatment. Results: The cause of DSA was diagnosed as cerebral arteriovenous malformation in 12 cases, surgical treatment in 10 cases, cerebral aneurysm in 16 cases, surgical treatment in 10 cases, moyamoya disease in 6 cases, surgical treatment in 2 cases, arteritis in 3 cases, unexplained 13 cases, A total of 6 deaths, the mortality rate of 8.3%. In the lumbar puncture group, 10 cases died, the fatality rate was 35.7%. There was significant difference between the two groups (P <0.05). Conclusion: In the early stage of acute SAH, DSA can detect the etiological diagnosis in time, so different treatment measures can be taken according to different etiology, significantly reducing the mortality and shortening the course of the disease. The method has greater clinical value and promotion prospects.