蛛网膜下腔出血患者意识状态的分析

目的：分析影响蛛网膜下腔出血（ＳＡＨ）患者意识障碍的相关因素，为临床抢救提供依据。方法：回顾性分析１９８０～１９９５年收治的３９５例ＳＡＨ患者的临床资料。结果：本组３９５例ＳＡＨ，病后发生意识障碍者２２２例（５６．２０％），无意识障碍者１７３例。有、无意识障碍两组病例病程中发生脑疝者分别为３４．６８％和６．３６％，并发肺炎者分别为１１．６２％和２．３１％，并发消化道出血者分别为８．１０％和１．７３％。两组病死率分别为３４．６８％和８．６７％。脑动脉瘤破裂所致ＳＡＨ２２８例中意识障碍者１３９例（６０．９６％），非动脉瘤所致ＳＡＨ１６７例中有意识障碍者８３例（４９．７０％）。结论：观察ＳＡＨ患者有无意识障碍有助于对患者预后的分析判断，应尽早进行脑血管造影检查，如有脑动脉瘤则应争取尽早采取外科手术进行病因治疗。

Disturbance of consciousness of patients with subarachnoid hemorrhage/

Objective:To analyse the effects of related factors on subarachnoid hemorrhage (SAH) and provide the basis for clinical treatment.Methods:The clinical data of 395 cases of hospitalized patients with SAH from 1980 to 1995 were retrospective analysed.Results:There were 222 cases were disturbance of consciousness (56 20%) and 173 cases were no disturbance of consciousness among 395 patients with stroke.The cerebral hernia rate was 34 68% in former group and 6 36% in latter group respectively.The incidences of complicated pneumonia was 11 62% in former group and 2 31% in latter group respectively,the incidences of complicated gastrointestinal bleeding was 8 10% in former group and 1 73% in latter group respectively.The mortality was 34 68% in former group and 8 67% in latter group respectively.There had 139 cases were coma in the 228 patients with SAH induced by rupture of aneurysm (60 96%) and 167 patients with SAH induced not by aneurysm(49 70%).Conclusions:The mortality,incidence of cerebral hernia,pneumonia and gastrointestinal bleeding in coma group were higher than noncoma group,the incidence of coma was higher in caused by aneurysm rupture than other.