颅内动脉瘤性蛛网膜下腔出血术后预后不良危险因素分析  

Risk Factors Analysis of Poor Prognosis in Patients with Subarachnoid Hemorrhage caused by Ruptured Aneurysms Post Operation

作　　者：刘永昌[1] 李少泉[1] 李连生[2] 王占强[1] 徐秀珍[1] 杨明[1] 白丽梅[1] 

机构地区：[1]河北省沧州市中心医院神经外科,河北沧州061000 [2]河北省黄骅市中西医结合医院神经外科,河北黄骅061100

出　　处：《医学临床研究》2016年第2期229-231,共3页Journal of Clinical Research

基　　金：河北省科技计划项目（编号：151302159）

摘　　要：【目的】 探讨进行颅内动脉瘤性蛛网膜下腔出血（SAH）术后预后不良的危险因素，以期为其早期临床评估和预防提供参考依据。【方法】 回顾性分析本院收治的120例接受手术治疗的动脉瘤性SAH患者临床资料，依据患者出院时格拉斯哥结局量表（GOS）评分将患者分为预后不良组（n=32）和预后良好组（n=88），对比两组一般资料的差异，以预后情况作为因变量，以各影响因素作为自变量并赋值，采用Logistic多元回归分析预后不良的危险因素。【结果】 预后不良组年龄偏大，多发性动脉瘤患者更多，Fisher分级以及HuntHess分级更高，两组比较差异具有统计学意义（P＜0.05）。Logistic多元回归分析结果显示，年龄、多发性动脉瘤、HuntHess分级是颅内动脉瘤性SAH术后预后不良的危险因素，OR值分别为3.259、1.353、1.656，差异具有统计学意义（P＜0.05）。【结论】 年龄大、多发性动脉瘤以及HuntHess分级的SAH患者术后预后不良的风险加大，临床要高度重视并针对性预防。【Objective】To explore the risk factors of poor prognosis in patients with subarachnoid hemorrhage caused by ruptured aneurysms post operation, so as to provide reference for early clinical evaluation and prevention. 【Methods】Retrospectively the clinical data of 120 SAH patients who underwent surgical treatment were collected and divided into poor prognosis group （32 cases） and good prognosis group （88 cases） according to the Glasgow outcome scale （GOS） score, the general data between the two groups were compared, the prognosis was set as the dependent variable, with various factors as independent variables and assignment, risk factors of poor prognosis were analyzed by Logistic regression . 【Results】 In poor prognosis group, the age was greater, the number of multiple aneurysm patients was larger, Fisher and grading Hunt  Hess classification were higher than those of the good prognosis group, the difference was statistically significant between the two groups （P〈0.05）; Logistic multivariate regression analysis results showed that age, multiple aneurysms, HuntHess classification were the risk factors of intracranial aneurysms after SAH poor prognosis, the OR values were respectively 3.259, 1.353, 1.656 , the difference was statistically significant （P〈0.05）. 【Conclusion】 Advanced age, multiple aneurysms and HuntHess classification of SAH patients had an increased risk of postoperative prognosis, thus more attention must be paid clinically and more relevant targeted prophylaxis needs to be taken.

关 键 词：颅内动脉瘤/并发症 蛛网膜下腔出血/病因学 蛛网膜下腔出血/外科学 

分 类 号：R743.35[医药卫生—神经病学与精神病学]