动脉瘤性蛛网膜下腔出血脑血管痉挛的原因分析及治疗  

Analysis on the risk factors and the therapeutic method of cerebral vasospasm following aneurysmal subarachnoid hemorrhage by interventional therapy

作　　者：林百喜[1] 武衡[1] 阳纲要[1] 谢明[1] 

机构地区：[1]南华大学第一附属医院神经内科,湖南衡阳421001

出　　处：《中国现代医学杂志》2009年第5期764-767,共4页China Journal of Modern Medicine

摘　　要：目的探讨动脉瘤性蛛网膜下腔出血后影响症状性血管痉挛发生的危险因素及治疗方法。方法对56例已行血管内介入治疗的动脉瘤性蛛网膜下腔出血患者的临床资料进行回顾性分析。结果共18例患者(32.14%)发生症状性血管痉挛,Hunt-Hess≥Ⅲ级,Fisher≥Ⅲ级症状性血管痉挛发生率高(P<0.05);入院及住院期间血糖水平越高,出现血管痉挛的比例越高(P<0.05),超过发病3d手术者其发生血管痉挛的几率也高于3d内手术者(P<0.05)。结论Hunt-Hess≥Ⅲ级、Fisher≥Ⅲ级、入院时血糖水平、住院期间血糖水平、手术时机是迟发性脑血管痉挛发生的独立危险因素。[Objective] To explore the risk factors and the therapeutic method of cerebral vasospasm following aneurysmal subaraehnoid hemorrhage （aSAH）. [Methods] The clinical and imaging data of 56 patients with aSAH by interventional therapy were analysed retrospectively. [Results] 18 patients （32.14%） had symptomatic cerebral vasospasm （CVS）. The incidence of cerebral vasospasm in the patients with Hunt-Hess scales≥Ⅲ, Fisher scales ≥Ⅲ was significantly higher than that in other patients （P 〈0.05）. The more higher mean admission blood glucose and mean inpatient blood glucose, the more higher CVS. The incidence of the cerebral vasospasm in the patients under- going the operation beyond three days after aSAH was significantly higher than that in the patients undergoing the operation within three days after aSAH （P 〈0.05）. [Conclusions] Fisher scale ≥Ⅲ, Hunt-Hess scales≥ Ⅲ, mean admission blood glucose, mean inpatient blood glucose and operation opportunity are the independent risk factors of cerebral vasospasm after aSAH.

关 键 词：颅内动脉瘤 蛛网膜下腔出血 脑血管痉挛 

分 类 号：R743.35[医药卫生—神经病学与精神病学]