| 蒋寅生,盛燚,欧伟根,李峰,吴龙川,杨洞洞.以心跳骤停为首发症状的蛛网膜下腔出血的共同特征的研究[J].浙江中西医结合杂志,2023,33(8): |
| 以心跳骤停为首发症状的蛛网膜下腔出血的共同特征的研究 |
| A study on the common characteristics of subarachnoid hemorrhage with cardiac arrest as the first symptomJiang yin sheng1 Sheng yi1 Ou wei gen1 Li feng1 Wu long chuan1 Yang dongdong2 |
| 投稿时间：2022-12-02 修订日期：2023-05-20 |
| DOI： |
| 中文关键词: 心脏骤停 蛛网膜下腔出血 恢复自主循环 心电图 脑死亡 |
| 英文关键词:cardiac arrest Subarachnoid hemorrhage Restoration of spontaneous circulation ECG Brain death |
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| 中文摘要: |
| 目的 探讨以心跳骤停为首发症状的蛛网膜下腔出血的患者在临床表现、心电图和预后方面的共同特征,为该类疾病的快速诊断提供方向,避免漏诊。方法 纳入浙江中医药大学附属第一医院及临平第一人民医院2015年1月至2019年12月确诊的以心跳骤停为首发症状的蛛网膜下腔出血患者16例,其中男性10例,女性6例。分析其自主循环恢复(ROSC)回复时间、ROSC后首次心电图特点、ROSC后体格检查及预后存在的共同特点。结果 此类患者存在以下共同特点：1.可以快速实现ROSC,用时较短；2.复苏成功后,意识丧失、自主呼吸消失、瞳孔散大且脑电图呈现电静息状态；3.心电图提示快室率房颤或窦性心动过速,avR导联ST段抬高,胸前导联出现ST段压低,其中窦性心律者还可出现肢体导联Ⅱ、Ⅲ、avF ST段压低。满足以上三点,应首先考虑蛛网膜下腔出血的可能,行头颅CT明确诊断。结论 心跳骤停经心肺复苏后快速恢复自主循环、心电图呈ST-T改变、出现脑死亡者可能是蛛网膜下腔出血致心脏骤停的特征。 |
| 英文摘要: |
| Objective To explore the common characteristics of clinical manifestations, electrocardiogram and prognosis of patients with subarachnoid hemorrhage(SAH) with cardiac arrest(CA) as the first symptom, so as to provide a direction for rapid diagnosis of this kind of disease and avoid missed diagnosis.Methods Sixteen patients with SAH diagnosed with CA as the first symptom from January 2015 to December 2019 in the First Affiliated Hospital of Zhejiang Chinese Medical University and the medical consortium hospital were included, including 10 males and 6 females. The recovery time of the restoration of spontaneous circulation(ROSC),the characteristics of the first ECG after ROSC, the physical examination after ROSC and the common characteristics of the prognosis were analyzed.Results These patients have the following common characteristics1:1.ROSC can realized quickly,in a short time.2. After ROSC,consciousness was lost,without spontaneous breathing,pupil dilated and electroencephalogram showed static state; 3. The ECG prompt fast ventricular rate of atrial fibrillation and sinus tachycardia,ST elevation in aVR with large ST depression in chest Leads, which sinus rhythm also appeared ST depression in II, III, avF leads.In line with the above three points, the possibility of SAH should be considered first, and the skull CT should be performed to make a definite diagnosis. Conclusion ROSC can realized quickly by cardiopulmonary resuscitation, and the ECG showed ST-T changes,concurrent brain death,which may be characteristics of CA due to SAH. |
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