64层螺旋CT血管造影在蛛网膜下腔出血诊断临床应用及护理.doc

64层螺旋CT血管造影在蛛网膜下腔出血诊断临床应用及护理【摘要】目的：探讨64层螺旋CT血管造影（CTA）在蛛网膜下腔出血(SAH)病因诊断中的运用及护理。方法：对2005年9月~2006年9月收治入院的89例SAH患者行64层螺旋CT血管造影检查，其中49例同时接受数字减影血管造影（DSA）检查。分析CTA检查结果并与DSA检查结果比较。结果：89例患者中CTA检出动脉瘤70例，动静脉畸形9例，静脉窦血栓2例，阴性8例；在同时接受DSA检查的49例患者中，发现动脉瘤41例，动静脉畸形4例，阴性4例，其中除1例CTA发现并经临床证实的动脉瘤DSA检查为阴性外，其余全部CTA确诊。CTA对SAH病因诊断中的敏感性和特异性均为100%，DSA分别为98%和100%。结论：64层螺旋CTA对SAH的病因诊断是一种无创、快速、便捷的影像学检查方法，做好检查时的护理配合，可使血管的空间立体结构及周边关系显示良好，有助于治疗方法的选择和难度的评估。 【关键词】蛛网膜下腔出血；CT血管造影术；诊断；颅内动脉瘤；护理 文章编号：1009-5519（2007）24-3654-03 中图分类号：R47 文献标识码：A Clinical application of 64-slices spiral CT angiography in diagnosing subarachnoid hemorrhage and Nursing care LI Xing-hua (Department of Neurosurgery，The First Affiliated Hospital， Chongqing Medical University，Chongqing 400016，China) 【Abstract】Objective：To evaluate the value of 64-slices spiral CT angiography (CTA) in the etiological diagnsis of subarachnoid haemorrhage (SAH) and nursing care. Methods：CTA was performed in 89 cases with spontaneous SAH admitted from September 2005 to September 2006，49 of which also underwent digital subtracted angiography(DSA). The findings of CTA were compared with the results of DSA.Results：Among the 89 patients，CTA revealed 69 cases with cerebral aneurysm，9 arteriovenous malformation(AVM)，2 thrombus of venous sinues，8 negative findings. Among the 49 patients who underwent both CTA and DSA，all but 1 lesions showed by CTA，either cerebral aneurysms(n=41) or AVMs(n=4)， were confirmed by DSA. DSA failed to show one case of small anterior communicating aneurysm demonstrated by CTA. It was found that CTA sensitivity and specificity were 100% and that DSA sensitivity was 98% and specificity was 100% in diagnosis of intracranial aneurysms in etiological diagnosis of SAH. Conclusion：64-slices spiral CTA is a non-invaise， fast convenience imaging modality for etiological diagnosis of the SAH and also plays an important role in selecting therapy and assessing difficulties of treatment. 【Ｋey words】Subarachnoid hemorrhage；CT