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近年来,为提高自发性蛛网膜下腔出血病人的临床治疗效果,人们对再出血进行了较多研究,认为早期手术(入院后24小时内)能预防发病后几天内发生再出血,然而超早期再出血(入院至早期手术的时间内)成为蛛网膜下腔出血患者临床结果恶化的主要难题。本研究目的在于判断超早期再出血的发生率及其危险因素。 本组179例(男71例,女108例),均在发病后24小时内入院并准备早期手术。入院时临床神经功能用Hunt and Hess分类法分级。入院后半小时内行脑CT扫描,根据CT示蛛网膜下腔内出血量分为四组,并均及时进行CT复查以确定有无再出血。入院后1小时内采取血液标本,测定了凝血系统中凝血酶原时间、部分凝血酶原时间、纤维蛋白原、抗凝血酶Ⅲ、凝血酶—抗凝血
In recent years, to improve the clinical efficacy of patients with spontaneous subarachnoid hemorrhage, there have been more studies on rebleeding, suggesting that early surgery (within 24 hours after admission) can prevent rebleeding within a few days after onset, however Ultra-early rebleeding (during admission to early surgery) is a major challenge in deteriorating clinical outcomes in patients with subarachnoid hemorrhage. The purpose of this study is to determine the incidence of ultra-early rebleeding and its risk factors. The group of 179 cases (71 males and 108 females), were admitted within 24 hours after onset and prepare for early surgery. Clinical neurological function at admission was graded using the Hunt and Hess classification. Within half an hour after admission brain CT scan, according to CT showed subarachnoid hemorrhage were divided into four groups, and are promptly conducted CT review to determine whether the rebleeding. Within 1 hour after admission, blood samples were taken and the prothrombin time, partial prothrombin time, fibrinogen, antithrombin III, thrombin-anticoagulant