《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (4): 364-366.

• 论文 • 上一篇    下一篇

蛛网膜下腔出血临床规范化路径对患者预后的影响

温淼，鞠奕，宋新杰，张玉梅，赵性泉   

  1. 首都医科大学附属北京天坛医院神经内科，北京市 100050。
  • 收稿日期:2010-02-02 修回日期:1900-01-01 出版日期:2010-04-25 发布日期:2010-04-25

Comparison of Prognosis of Acute Subarachnoid Hemorrhage within or without Clinical Standardized Pathway

WEN Miao, JU Yi, SONG Xin-jie, et al.   

  1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
  • Received:2010-02-02 Revised:1900-01-01 Published:2010-04-25 Online:2010-04-25

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摘要： 目的探讨蛛网膜下腔出血临床规范化路径对蛛网膜下腔出血(SAH)患者预后的影响。方法收集2005～2009年在本院神经内科监护病房的急性期(发病72 h内)蛛网膜下腔出血患者，其中蛛网膜下腔出血临床规范化路径建立前的患者123例，建立后的患者146例，分别采集患者的性别、年龄、Hunt-Hess、Fisher分级等基线信息，完成全脑血管造影术(DSA)的时间和结果，如发现责任动脉瘤给予动脉瘤处理的时间、发病前和出院时患者改良的Rankin量表 (Modified Rankin Scale, MRS) 评分，比较两组患者再出血率、并发症发生率、死亡率、预后及平均住院日等。结果两组患者再出血、继发脑血管痉挛、脑积水发生率及死亡率、临床预后、平均住院日存在显著性差异(P<0-05)。结论蛛网膜下腔出血临床规范化路径的建立使早期动脉瘤性蛛网膜下腔出血患者的临床预后得到改善。

关键词: 蛛网膜下腔出血, 动脉瘤, 临床规范化路径, 并发症, 死亡率, 预后

Abstract: ObjectiveTo compare the prognosis of patiens with acute(within 72 hours) subarachnoid hemorrhage (SAH) within or without the clinical standardized pathway(CSP).Methods123 acute SAH cases were collected before CSP established meanwhile another 146 cases after CSP established from 2005 to 2009 in neurological intensive care unit of our hospital. Information such as age, gender, Hunt-Hess and CT-Fisher grade, timing and result of digital subtraction arteriography, treating time of aneurysm, and Modified Rankin Scale(MRS) at different time were recorded. Rehaemorrhagia, complications, mortality, prognosis and average stay were compared between two groups.ResultsThere was a significant difference between two groups in rehaemorrhagia, vasospasm，hydrocephaly, mortality, prognosis and average stay.ConclusionCSP is helpful to improve the prognosis of aneurysm subarachnoid hemorrhage.

Key words: subarachnoid hemorrhage, aneurysm, clinical standardized pathway, complication, mortality, prognosis