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目的探讨在基层医院脑血管造影条件不完善情况下脑动静脉畸形破裂出血的诊断及治疗。方法对59例脑动静脉畸形破裂出血患者与同期收治的174例高血压脑出血患者从年龄、血肿部位及形态、出血后血压变化及应用甘露醇是否有效几方面作回顾性对比分析。结果我们发现脑动静脉畸形出血患者平均年龄低,出血部位多在皮层下,形态不规则,呈弧形凹入或尖角形,出血后血压正常或一过性收缩压增高,用甘露醇后可下降。结论在基层医院,无脑血管造影条件下,脑动静脉畸形出血术前可根据患者年龄、出血部位、血肿形态,以及出血后血压升高用甘露醇是否有效做出初步判断,术中多数可确诊。治疗上需根据患者意识情况和血肿量多少选择是否保守或手术。手术治疗是可靠的方法,但由于手术前无脑血管造影,术后致残率较高。
Objective To investigate the diagnosis and treatment of cerebral arteriovenous malformation rupture (HAP) under the conditions of cerebral angiography in primary hospitals. Methods A retrospective analysis of 59 patients with cerebral arteriovenous malformation rupture and 174 patients with hypertensive intracerebral hemorrhage treated in the same period were retrospectively analyzed in terms of age, location and morphology of the hematoma, blood pressure changes after the bleeding and whether mannitol was effective. Results We found that the mean age of patients with cerebral arteriovenous malformation bleeding is low, the bleeding sites are mostly in the cortex, irregular in shape, concave or pointed arc-shaped bleeding after the blood pressure normal or transient systolic blood pressure increased with mannitol decline. Conclusions In primary hospital, without cerebral angiography, cerebral arteriovenous malformations can be preliminarily judged according to the patient’s age, site of bleeding, morphology of hematoma, and whether the mannitol is effective after hemorrhage. Confirmed. Treatment should be based on patient awareness and how much the amount of choice of hematoma is conservative or surgery. Surgical treatment is a reliable method, but because of no cerebral angiography before surgery, the postoperative morbidity is high.