Kellner P, Stoevesandt D, Soukup J, Bucher M, Raspé C
Klinik für Anästhesiologie und operative Intensivmedizin, Martin-Luther-Universität, Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle a.d. Saale, Deutschland.
Anaesthesist. 2012 Sep;61(9):792-814. doi: 10.1007/s00101-012-2077-2.
Acute subarachnoid hemorrhage (SAH) is a severe and acute life-threatening cerebrovascular disease. Approximately 80% of all acute non-traumatic SAHs are the result of a ruptured cerebrovascular aneurysm. Despite advances in diagnosis and treatment a high morbidity and mortality still exists. Apart from the primary cerebral damage there are also secondary complications, such as vasospasm, rebleeding, hydrocephalus, cerebral edema or hydrocephalus. For an appropriate therapy an understanding of the extensive pathophysiology, the options in diagnostics and therapy and the complications of the disease are essential. Anesthesiologists are decisively involved in the therapy of the primary and secondary damages and subsequently in the outcome as well. This article provides an overview of the perioperative and intensive care management of patients with SAH.
急性蛛网膜下腔出血(SAH)是一种严重的、危及生命的急性脑血管疾病。所有急性非创伤性SAH中约80%是脑血管动脉瘤破裂所致。尽管在诊断和治疗方面取得了进展,但高发病率和死亡率仍然存在。除了原发性脑损伤外,还存在继发性并发症,如血管痉挛、再出血、脑积水、脑水肿或脑积水。为了进行适当的治疗,了解广泛的病理生理学、诊断和治疗选择以及该疾病的并发症至关重要。麻醉医生在原发性和继发性损伤的治疗中起决定性作用,进而对治疗结果也起决定性作用。本文概述了SAH患者的围手术期和重症监护管理。