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[动脉瘤性蛛网膜下腔出血——治疗与并发症]

[Aneurysmal subarachnoid hemorrhage - therapy and complications].

作者信息

Seule Martin A, Stienen Martin N, Cadosch Dieter, Fournier Jean-Yves, Lussmann Roger, Hildebrandt Gerhard, Gautschi Oliver P

机构信息

Neurochirurgie am Kantonsspital St. Gallen. Seine Schwerpunkte sind das Neuromonitoring und zerebrovaskuläre Erkrankungen.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2010 Jan;45(1):8-17. doi: 10.1055/s-0029-1243372. Epub 2010 Jan 20.

Abstract

The management of patients with aneurysmal subarachnoid hemorrhage (SAH) requires a fundamental knowledge of the disease, its therapeutic options and possible complications. The preoperative goal is to prevent rebleeding by controlling blood pressure and treating pain and anxiety as well as stabilizing cardiopulmonary functions. An acute hydrocephalus has to be treated immediately. Microsurgical clipping or endovascular coiling are the therapeutic options available. The postoperative goal aims at securing cardiopulmonary functions as well as recognizing and treating cerebral (cerebral vasospasm, hydrocephalus, epilepsy) and systemic complications (electrolyte disorder, cardiac dysfunction). This article provides an overview about the pre-, peri- and postoperative management of patients with SAH.

摘要

动脉瘤性蛛网膜下腔出血(SAH)患者的管理需要对该疾病、其治疗选择及可能的并发症有基本的了解。术前目标是通过控制血压、治疗疼痛和焦虑以及稳定心肺功能来预防再出血。急性脑积水必须立即治疗。显微手术夹闭或血管内栓塞是可用的治疗选择。术后目标旨在确保心肺功能以及识别和治疗脑部(脑血管痉挛、脑积水、癫痫)和全身并发症(电解质紊乱、心脏功能障碍)。本文概述了SAH患者的术前、围手术期和术后管理。

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