Bleck T P
Neurosciences ICU, The University of Virginia, Charlottesville 22908, USA.
New Horiz. 1997 Nov;5(4):387-96.
The medical management of the subarachnoid hemorrhage patient has changed considerably over the past two decades. The widespread acceptance of early aneurysm obliteration allows the aggressive prophylaxis and treatment of many of the serious complications of this condition. Recognition of cerebral vasospasm and the prevention of the delayed ischemic deficits it can produce are the cornerstones of critical care for these patients. Analysis of their fluid and electrolyte disturbances is complex, but important for the optimization of intravascular volume and consequent cerebral blood flow. Recognition of the numerous infectious and other medical complications that can befall these patients aids in the attempt to restore them to as normal a functional capacity as is possible.
在过去二十年中，蛛网膜下腔出血患者的医疗管理发生了相当大的变化。早期动脉瘤闭塞术的广泛接受使得能够积极预防和治疗该疾病的许多严重并发症。认识到脑血管痉挛及其可能导致的迟发性缺血性神经功能缺损并加以预防，是这些患者重症监护的基石。对其体液和电解质紊乱的分析很复杂，但对于优化血管内容量和随之而来的脑血流量很重要。认识到这些患者可能遭遇的众多感染性和其他医疗并发症，有助于努力使他们尽可能恢复到正常的功能能力。
