论文部分内容阅读
作者估价了自发性蜘网膜下腔出血后腰穿的价值及其危险性,并评价了计算机断层摄影(computedtomograpby,CT)对避免这些危险性的作用。74例确诊为自发性蜘网膜下腔出血的患者有63例作了 CT、及血管造影术,1例仅行 CT,55例作了腰穿检查(均于发病12h 内作腰穿,44例检查于 CT 之前)。7例腰穿后意识与神经系统状态明显恶化,这7例于腰穿前均无行 CT,其中3例存活。腰穿后作 CT、血管造影和手术均证实有大脑内血块引起的大脑移位。4例死亡:其中3例尸检证实有大脑移位和小脑幕及扁桃体疝;另1例腰穿时神志清楚,单侧瞳孔散大,于穿刺结束时呼吸骤停,未作尸检。64例行 CT 检查者发病后3天内检查,59例(92%)有出血证据,5天内检
The authors assessed the value and risk of lumbar puncture after spontaneous sub-subarachnoid hemorrhage and evaluated the effect of computed tomography (CT) on avoiding these risks. Of the 74 patients diagnosed as having spontaneous subarachnoid hemorrhage, 63 underwent CT and angiography, 1 underwent CT scan only and 55 underwent lumbar puncture (all lumbar puncture within 12 h of onset, 44 Example check before CT). Seven patients had significant deterioration of their consciousness and nervous system status after lumbar puncture. None of the 7 patients had CT before lumbar puncture, and 3 of them survived. After lumbar puncture for CT, angiography and surgery were confirmed by cerebral blood clots caused by brain displacement. 4 died: 3 of the autopsy confirmed the brain shift and the tentorium of the cerebellum and tonsil hernia; the other 1 case of lumbar puncture conscious, unilateral mydriasis, respiratory arrest at the end of the puncture, no autopsy. Sixty-four routine CT examinations were performed within 3 days after onset, 59 (92%) had evidence of bleeding, and 5 days