【摘要】 目的探讨动脉瘤性SAH后脑积水的临床特点及诊治方法。方法根据发病时间将SAH后的脑积水分为急性、亚急性和慢性3期,并对36例动脉瘤性SAH后脑积水患者行头颅CT检查,分析其临床特点及诊断标准;治疗采用脑室外引流术11例,脑室-腹腔分流术25例。结果全组均被诊断为脑积水。经治疗后临床状况改善情况:明显改善31例,好转5例;CT扫描显示脑室情况:正常29例,明显缩小5例,稍缩小2例。临床治愈34例,2例复发者经2次脑室-腹腔分流术后治愈。结论动脉瘤性蛛网膜下腔出血后可以形成急性、亚急性或慢性脑积水;CT是诊断脑积水首选的主要方法;根据不同类型对脑积水进行脑室外引流或脑室-腹腔分流术的方法疗效可靠。更多还原

【Abstract】 [Objective] To discuss the clinical characteristic, diagnosis and treatment of hydrocephalus after aneurysmal subarachnoid hemorrhage. [Methods] The course of hydrocephalus after aneurpsmal SAH were divided iuto acute, subacute and chronic phase according to the onset time and 36 cases with hydrocephalus were accepted CT scan. We analyzed their clinical characteristic and diagnostic criteria. among them, 11 cases were adopted external ventricular drainage and 25 cases were adopted ventriculo-peritoneal shunt method. [Results] The whole cases were diagnosed as hydrocephalus. The improvement of clinical status after treatment as follow: 31 cases were obviously improved, 5 cases got cured. The cerebral ventricle status under CT scan: 29 cases got normal, 5 cases got obviously deflate, 2 cases got a little deflate. 34 cases got clinical cured, 2 cases got recured and finally got clinical cured when treated with second ventriculo-peritoneal shunt method. [Conclusions] Aneurysmal subarachnoid hemorrhage can cause hydrocephalus; CT scan is the first choice to diagnosis of hydrocephalus; the effect of hydrocephalus treatment by esternal ventricular drainage and ventriculo-peritoneal shunt is realiable and significant.更多还原