原发性蛛网膜下腔出血502例临床分析

目的 总结原发性蛛网膜下腔出血(SAH)的临床特点、影像学特征、并发症和预后.方法 回顾性分析总结502例SAH患者的临床资料.结果 84.3%(423/496)患者以剧烈头痛为主要症状,13.1%(66/496)出现头晕或眩晕,意识障碍占27.5%(138/496),局灶性神经功能缺损体征58.2%(292/496),脑膜刺激征阳性72.5%(364/496),数字减影血管造影术检查阳性率54.1%(93/172),病因以动脉瘤最常见占20.1%(101/496).绝大部分预后好,老年人病死率高.结论 SAH病因复杂,临床表现多样化,脑血管造影常可明确病因,多数患者恢复良好.

Clinical analysis of 502 cases of subarachnoid hemorrhage

Objective To summarize the clinical and imaging features of subarachnoid hemorrhage(SAH) and its complications and prognosis. Methods The clinical data of 502 cases of SAH were retrospectively analyzed and summarized. Results There were 84.3 % (423/496) patients sufferring from intense headache, dizziness or vertigo (13. 1%, 66/496 ), disturbance of consciousness ( 27. 5%, 138/496 ), partial neurologic impairment (58.2% ,292/496) ,meningeal irritation sign(72.5% ,364/496). The positive rate of digital subtraction angiogra-phy was 54.1% (93/172). Aneurysm was the common reason of SAH (20. 1%, 101/496). Prognosis in most pa-tients was better,but the old patients suffered from high mortality. Conclusions The cause and clinical manifesta-tion of SAH varies,cerebral angiography often could help find the cause of SAH. Most SAH patients recover well.