自发性脑室出血后脑积水的危险因素分析  

Risk factors for hydrocephalus in patients with spontaneous intraventricular hemorrhage

作　　者：徐华中 黄保胜 XU Huazhong;HUAN Baosheng(Sir Run Run Hospital,Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属逸夫医院,江苏南京210000

出　　处：《中国实用神经疾病杂志》2020年第16期1381-1385,共5页Chinese Journal of Practical Nervous Diseases

基　　金：江苏省自然科学基金(编号:BK20171064);江苏省科技强卫工程青年医学人才基金(编号:QNRC2016858)。

摘　　要：目的探讨自发性脑室出血后形成脑积水的相关危险因素,以指导临床治疗决策。方法回顾性分析南京医科大学附属逸夫医院2016-06—2020-05收治的152例自发性脑室出血患者的临床资料,其中脑室出血后发生脑积水67例,未发生脑积水85例。将2组患者性别、年龄、格拉斯哥昏迷评分(GCS)、原发出血部位、有无脑疝、Graeb评分、受累及的脑室数量和颅内感染等指标进行比较,多因素Logistic回归分析脑室出血后发生脑积水的危险因素。结果与未发生脑积水组相比,发生脑积水组患者GCS评分≤8分、Graeb评分≥6分、受累及的脑室数量和颅内感染比例较高,差异有统计学意义(P<0.05);2组性别、年龄、脑疝、原发出血部位差异无统计学意义(P>0.05)。多因素Logistic回归分析表明GCS评分≤8分、Graeb评分≥6分和颅内感染是自发性脑室出血后发生脑积水的独立危险因素。结论GCS评分、Graeb评分以及是否并发颅内感染是影响自发性脑室内出血后发生脑积水的重要因素。Objective To evaluate potential risk factors for hydrocephalus in patients with spontaneous intraventricular hemorrhage so as to guide the clinical decision.Methods The clinical data of 152 patients with spontaneous ventricular hemorrhage admitted to the Sir Run Run Hospital of Nanjing Medical University from June 2016 to May 2020 were retrospectively analyzed.Among them,67 cases of hydrocephalus occurred after intraventricular hemorrhage and 85 cases did not occur.The two groups of patients were compared with indicators such as gender,age,Glasgow coma score(GCS),original bleeding site,presence or absence of cerebral hernia,Graeb score,number of ventricles involved,and intracranial infection.Multivariate Logistic regression analysis was used to study ventricular hemorrhage risk factors for hydrocephalus afterwards.Results Compared with no hydrocephalus group,the proportions of hydrocephalus group in GCS≤8,Graeb classification≥6,ventricles and intracranial infection were significantly higher(P<0.05).There were no significant differences between the 2 groups in gender,age,cerebral hernia,hemorrhage location(P>0.05).According to multivariate analysis,GCS≤8,Graeb classification≥6,and intracranial infection were independent risk factors for hydrocephalus in patients with spontaneous intraventricular hemorrhage.Conclusion GCS,Graeb classification and intracranial were the most important factors affecting incidence of hydrocephalus after spontaneous intraventricular hemorrhage.

关 键 词：脑积水 脑室出血 自发性脑出血 Graeb评分 危险因素 

分 类 号：R742.7[医药卫生—神经病学与精神病学]