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本文总结了蛛网膜下腔出血93例。经检查明确有脑血管畸形4例、动脉瘤1例、颅内占位性病变2例和烟雾病2例。因症状不典型致早期误诊20例。故认为突然剧烈的头痛,并与以前发作不同的头痛,即使无颈项强直,也应做腰穿检查以减少误诊。从预后因素分析,年龄≥55岁、入院时血压增高和意识障碍者,病死率增高5～10倍,与出血量增多有关。为提高疗效,对部分严重病例脱水剂使用适当延长,注意水电解质平衡,预防并发症和运用中医中药等。
This article summarizes 93 cases of subarachnoid hemorrhage. After examination clearly cerebral vascular malformations in 4 cases, aneurysm in 1 case, intracranial space-occupying lesions in 2 cases and moyamoya disease in 2 cases. 20 cases were misdiagnosed due to atypical symptoms. Therefore, it is considered a sudden severe headache and a headache different from the previous episode. Even if there is no neck rigidity, we should do a lumbar puncture examination to reduce misdiagnosis. From the prognostic factor analysis, age ≥ 55 years old, admission to patients with hypertension and unconsciousness, mortality increased 5 to 10 times, and increased bleeding. In order to improve the curative effect, we should appropriately extend the use of dehydrating agent in some serious cases, pay attention to the balance of water and electrolyte, prevent complications and use traditional Chinese medicine.