文章摘要
程新富张志强△ 陈红庆刘宗霖程坤.老年蛛网膜下腔出血的治疗方法和预后分析[J].,2014,14(5):915-916
老年蛛网膜下腔出血的治疗方法和预后分析
Analysis of the Treatment and Prognosis of Elderly Patients withSubarachnoid Hemorrhage
  
DOI:
中文关键词: 蛛网膜下腔出血  老年患者  治疗  预后
英文关键词: Subarachnoid hemorrhage  Elderly patient  Treatment  Prognosis
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作者单位
程新富张志强△ 陈红庆刘宗霖程坤 解放军161中心医院神经外科 
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中文摘要:
      摘要目的:探讨70 岁以上老年蛛网膜下腔出血患者的治疗方法和预后。方法:回顾性分析我院2006-2012 年收治的49 例老年蛛 网膜下腔出血患者的临床资料及其预后。结果:49例患者入院时Hunt-Hess 分级:Ⅰ级14 例,Ⅱ级8 例,Ⅲ级6 例,Ⅳ级6 例,Ⅴ 级15 例,其中14 例采用开颅动脉瘤夹闭术,10 例采用血管内介入栓塞术,25例采用内科保守治疗。治疗后6 月,根据ADL量表 评价预后(ADL逸60 分为预后良好):内科保守治疗者仅3 例预后良好,手术及栓塞术者17 例预后良好。结论:对于老年蛛网膜下 腔出血患者而言,影响患者预后的原因主要是出血导致的脑损伤和症状性脑血管痉挛,通过手术或栓塞术积极治疗破裂动脉瘤 是预后良好的重要因素。
英文摘要:
      ABSTRACT Objective:To analyze the treatment and prognosis of patients over 70 years old with subarachnoid hemorrhage (SAH). Methods:A retrospective research was performed on 49 cases of elderly patients with subarachnoid hemorrhage admitted fromJune 2006 to June 2012 to analyze the treatment and prognosis of elderly patients with subarachnoid hemorrhage.Results: The Hunt-Hess grade on admission revealed that 14 patients were Grade Ⅰ, 8 cases of Grade II,6 cases of Grade III,6 cases of Grade IV and 15 cases of Grade V. 14 patients underwent surgical clipping, 10 patients underwent coil embolization, 25 patients received conservative therapy. The overall results evaluated for ADL (activities of daily living) after 6 months were as follows: 3 patients in the conservative group had a favorable outcome (ADL逸60), 17patients in the operative and coil embolization group had favorable outcomes. Conclusion:Unfavorable outcomes were caused mainly by primary brain damage and symptomatic vasospasm in elderly SAH patients, radical treatment of ruptured aneurysmby surgical clipping or coil embolization was important to achieve a favorable outcome.
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