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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 investigate the early treatment of spontaneous subarachnoid hemorrhage in primary hospital. Methods The clinical data of 35 patients with acute spontaneous subarachnoid hemorrhage from February 2012 to February 2013 were retrospectively analyzed. Results Totally 27 cases were referred from 29 cases of Hunt-Hess grade Ⅰ ~ Ⅲ patients at the early stage, the referral rate was 93.10%. There was no aggravating condition in all the referral patients. One patient died of rebleeding during the referral. One case refused to referral and re-bleeding occurred after one week of conservative treatment. Ⅳ ~ Ⅴ 6 cases, early referral in 0 cases, 1 case of conservative treatment after 1 week condition was improved referral, unconventional discharge (give up treatment or death) in 5 cases. Conclusions The early referral rate of primary hospital for Hunt-Hess Ⅰ-Ⅲ grade SAH patients is high. It is safe to give early referral. The severe stage Ⅳ-Ⅴ critically ill patients have poor prognosis and most of them are discharged unconditionally.