动脉瘤性蛛网膜下腔出血后慢性脑积水形成的相关因素分析  

Related Factors of Chronic Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage

作　　者：袁晓东[1] 吴过[1] 熊建平[1] 李锐[1] 

机构地区：[1]四川省巴中市中心医院神经外科,636600

出　　处：《实用心脑肺血管病杂志》2015年第5期59-61,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的分析动脉瘤性蛛网膜下腔出血后慢性脑积水形成的相关因素。方法选择2011年1月—2014年2月巴中市中心医院神经外科收治的动脉瘤性蛛网膜下腔出血患者143例,根据患者是否有慢性脑积水形成分为慢性脑积水组23例和非慢性脑积水组120例。回顾性分析两组患者的临床资料,包括性别、年龄、吸烟史、饮酒史、高血压病史、出血是否破入脑室、动脉瘤位置、出血次数、Hunt-Hess分级及Fisher分级等。结果两组患者性别、吸烟史和饮酒史阳性率及动脉瘤位置比较,差异无统计学意义(P>0.05);慢性脑积水组患者年龄、Hunt-Hess分级和Fisher分级大于非慢性脑积水组,高血压病史阳性率和出血破入脑室发生率高于非慢性脑积水组,出血次数多于非慢性脑积水组(P<0.05)。多因素Logistic回归分析结果显示,高龄〔OR=1.83,95%CI(1.21,2.59)〕、高血压病史〔OR=2.09,95%CI(1.46,3.14)〕、出血破入脑室〔OR=2.01,95%CI(1.27,3.09)〕、多次出血〔OR=1.95,95%CI(1.42,3.61)〕、Hunt-Hess分级较高〔OR=2.82,95%CI(1.79,4.28)〕及Fisher分级较高〔OR=2.12,95%CI(1.58,3.90)〕是动脉瘤性蛛网膜下腔出血后慢性脑积水形成的危险因素(P<0.05)。结论高龄、有高血压病史、出血破入脑室、多次出血、Hunt-Hess分级较高及Fisher分级较高的动脉瘤性蛛网膜下腔出血患者易并发慢性脑积水。Objective To analyze the related factors of chronic hydrocephalus after aneurysmal subarachnoid hemorrhage.Methods From January 2011 to February 2014,a total of 143 patients with aneurysmal subarachnoid hemorrhage were selected in the Department of Neurosurgery,the Central Hospital of Bazhong,and they were divided into case group（with chronic hydrocephalus,n = 23） and control group（without chronic hydrocephalus,n = 120） according to the incidence of chronic hydrocephalus.Clinical data including gender,age,smoking history,drinking history,hypertension history,hemorrhage breaking into ventricle or not,aneurysm locations,bleeding times,Hunt-Hess grade and Fisher grade were retrospectively analyzed.Results No statistically significant differences of gender,smoking history,drinking history or aneurysm locations was found between the two groups（P〉0.05）;age,Hunt-Hess grade and Fisher grade of case group were statistically significantly larger than those of control group,positive rate of hypertension history and incidence of hemorrhage breaking into ventricle of case group were statistically significantly higher than that of control group,bleeding times of case group was statistically significantly more than that of control group（P〈0.05）.Multivariate Logistic regression analysis showed that,age 〔OR = 1.83,95% CI（1.21,2.59） 〕,hypertension history 〔OR = 2.09,95% CI（1.46,3.14） 〕,hemorrhage breaking into ventricle 〔OR = 2.01,95% CI（1.27,3.09） 〕,more than once bleeding 〔OR = 1.95,95% CI（1.42,3.61） 〕,Hunt-Hess grade 〔OR = 2.82,95% CI（1.79,4.28） 〕 and Fisher grade 〔OR = 2.12,95% CI（1.58,3.90） 〕were risk factors of chronic hydrocephalus after aneurysmal subarachnoid hemorrhage（P〈0.05）.Conclusion Age,hypertension history,hemorrhage breaking into ventricle,more than once bleeding,Hunt-Hess grade and Fisher grade are risk factors of chronic hydrocephalus after aneurysmal subarachnoid hemorrhage,aneurysmal subarachnoid hemorrhage patients with above risk facto

关 键 词：蛛网膜下腔出血 动脉瘤 脑积水 危险因素 

分 类 号：R743.35[医药卫生—神经病学与精神病学]