脑室积血与动脉瘤性蛛网膜下腔出血患者预后的关系  

Relationship between intraventricular hemorrhage and prognosis of aneurysmal subarachnoid hemorrhage

作　　者：梁锐[1] 张国锋[1] 唐尤佳 LIANG Rui;ZHANG Guofeng;TANG Youjia(Department of Neurosurgery,Jiujiang First People′s Hospital,Jiangxi Province,Jiujiang,332000,China)

机构地区：[1]江西省九江市第一人民医院神经外科,江西九江332000

出　　处：《中国当代医药》2022年第22期66-69,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220201464)。

摘　　要：目的探讨脑室积血(IVH)与动脉瘤性蛛网膜下腔出血(aSAH)患者预后的关系。方法选取2016年1月至2021年1月江西省九江市第一人民医院神经外科收治的60例合并IVH的aSAH患者作为研究对象,所有患者入院后均完善检查之后治疗动脉瘤,计算蛛网膜下腔出血(SAH)总量评分与IVH体积。采用改良Rankin量表(mRS)将60例患者按照预后水平分为预后良好组(mRS分级为0~2级,n=42)和预后较差组(mRS分级为3~6级,n=18)。采用受试者工作特征曲线(ROC)分析SAH总量评分、IVH体积对合并IVH的aSAH患者预后不良的预测价值。结果预后良好组与预后较差组的动脉瘤大小比较,差异无统计学意义(P>0.05);预后良好组的SAH总量评分与IVH体积低于预后较差组,差异有统计学意义(P<0.05);SAH总量评分和IVH体积预测不良预后的AUC分别为0.676和0.702,联合检测的预测价值更高(AUC=0.823,95%CI=0.710~0.935,P<0.001)。结论预后良好的合并IVH的aSAH患者,其SAH总量评分与IVH体积均低于预后较差的患者,临床可通过SAH总量评分与IVH体积联合检测,来提高对疾病预后不良的诊断效能。Objective To investigate the relationship between intraventricular hemorrhage(IVH)and prognosis of aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 60 aSAH patients with IVH admitted to the Department of Neurosurgery of Jiujiang First People′s Hospital,Jiangxi Province from January 2016 to January 2021 were selected as the research subjects.All patients were treated for aneurysm after completing examination after admission,and the score of total subarachnoid hemorrhage(SAH)and IVH volume were calculated.According to prognosis level by modified Rankin rating scale(mRS),sixty patients were divided into good prognosis group(mRS grade was 0 to 2,n=42)and poor prognosis group(mRS grade was 3 to 6,n=18).Receiver operating characteristic curve(ROC)was used to analyze the predictive value of score of total SAH and IVH volume for poor prognosis of aSAH patients with IVH.Results There was no significant difference in aneurysm size between the good prognosis group and the poor prognosis group(P>0.05).The score of total SAH and IVH volume in the good prognosis group were lower than those in the poor prognosis group,with statistically significant differences(P<0.05).The AUC of score of total SAH and IVH volume in predicting poor prognosis was 0.676 and 0.702,respectively,and the predictive value of combined detection was higher(AUC=0.823,95%CI=0.710-0.935,P<0.001).Conclusion The score of total SAH and IVH volume of aSAH patients with IVH patients with good prognosis were lower than those with poor prognosis.Clinically,score of total SAH and IVH volume can be combined to improve the diagnostic efficiency of poor prognosis.

关 键 词：脑室积血 动脉瘤性蛛网膜下腔出血 受试者工作特征曲线 预后 

分 类 号：R651.1[医药卫生—外科学]