蛛网膜下腔出血病因、症状和预后的相关性分析

目的 探讨原发性蛛网膜下腔出血（subarachnoid hemorrhage，SAH）的病因、症状和预后的相关性。方法 回顾性分析了167例SAH患者病因、症状，恶化和死亡患者的主要病因和症状。结果 动脉瘤是SAH患者的主要病因，以中青年多见；高血压动脉硬化次之，以中老年多见；血管畸形所致的SAH以青年多见。头痛、呕吐和脑膜刺激征等SAH的典型症状在中青年患者中常见，肌力、精神症状和语言障碍等不典型症状在老年SAH患者中常见。恶化、死亡的24例SAH以〈45岁、出血后14d内多见，多以后枕部疼痛、意识障碍为首发症状，后颅窝出血为常见出血部位。结论动脉瘤和血管畸形是中青年SAH患者的主要病因，高血压动脉硬化、动脉瘤是老年患者主要病因；老年SAH患者临床症状不如中青年患者典型；后颅窝出血所致的SAH是〈45岁患者恶化死亡主要原因，多发生在出血后14d内。

Clinical analyses of etiopathogenisis, symptom and prognostic of spontaneous subarachnoid hemorrhage

Objective To explore clinical characteristics of spontaneous subarachnoid hemorrhage(SAM)pa- tients.Methods Etiopathogenisis and clinical manifestations of 167 SAIl patients of different ages and cause of 24 SAH patients' exacerbation and death were retrospectively analyzed.Results The aneurysm was the main etiologies of SAH.The youth and middle-ages SAH patients were caused by aneurysm.Hypertensive arteriosclerosis was the second etiologies of SAH which was mainly in middle-ages and old ages.SAH caused by Vascular malformation main- ly appeared in youth group.Headache and vomitus and meningeal irritation sign which mainly appeared in youth and middle-ages groups.Occiput pain and conscious disturbance was mainly the first symptoms of aggravation and death of SAH which happened in 14 days after hemorrhage and under 45 year ages.Conclusion Aneurysm and vascular malformations are the main causes of SAH of young patients.And hypertensive arteriosclerosis is the main cause of the old.The clinical manifestations of the old are not as typical as the young.Posterior cranial fossa hemorrhage is the main cause of SAH patients which are mostly under 45 year ages and mostly happen in 14 days after bleeding.