蛛网膜下腔出血患者出血的高危因素及预防措施  

High risk factors and preventive measures in patients with subarachnoid hemorrhage

作　　者：罗丽[1] 王丽雯 彭艳媛 LUO Li;WANG Li-wen;PENG Yan-yuan(The Second Affiliated Hospital of Nanchang University,Nanchang 330000,Jiangxi,China)

机构地区：[1]南昌大学第二附属医院,江西南昌330000

出　　处：《青岛医药卫生》2023年第1期21-24,共4页Qingdao Medical Journal

摘　　要：目的探讨蛛网膜下腔出血(Subarachnoid hemorrhage,SAH)患者出血的危险因素,为制定针对性预防措施提供指导。方法选择2020年4月至2022年4月本院收治的SAH患者73例。以患者首次出血后30d内是否出现再次出血为依据分为出血组(n=12)、未出血组(n=61)。分析两组临床资料,先进行单因素分析,将有差异的项目纳入Logistic回归系统进行多因素分析。结果单因素分析显示,动脉瘤直径、改良Fisher分级、Hunt-Hess分级、合并高血压、合并癫痫与SAH患者出现再出血有关,差异有统计学意义(P<0.05);年龄、性别、脑室外引流、高血脂、糖尿病、动脉瘤位置、动脉瘤数量与SAH患者出现再出血无关,差异无统计学意义(P>0.05);Logistic回归分析显示,动脉瘤直径≥10mm、改良Fisher分级Ⅲ~Ⅳ级、Hunt-Hess分级Ⅲ~Ⅳ级、合并高血压、合并癫痫是SAH患者再出血的高危因素(P<0.05)。结论动脉瘤直径≥10mm、改良Fisher分级Ⅲ~Ⅳ级、Hunt-Hess分级Ⅲ~Ⅳ级、合并高血压、合并癫痫是SAH患者再出血的高危因素,临床需采取相关预防措施,积极控制再出血,改善预后。Objective To investigate the risk factors of hemorrhage in patients with subarachnoid hemorrhage(SAH),and to provide guidance for the development of targeted preventive measures.Methods A total of 73 patients with SAH admitted to our hospital from April 2020 to April 2022 were chosen and divided into bleeding group(n=12)and non-bleeding group(n=61)according to whether rebleeding occurred within 30 days after the first bleeding.The clinical data of the two groups were collected.Univariate analysis was performed first,and the items with differences were included in the Logistic regression system for multivariate analysis.Results Univariate analysis showed that aneurysm diameter,modified Fisher grade,Hunt-Hess grade,hypertension and epilepsy were associated with rebleeding in SAH patients,and the differences were statistically significant(P<0.05).Age,gender,external ventricular drainage,hyperlipidemia,diabetes,aneurysm location and number of aneurysms were not associated with rebleeding in SAH patients,and the differences were not statistically significant(P>0.05).Logistic regression analysis showed that aneurysm diameter≥10mm,modified Fisher gradeⅢ-Ⅳ,Hunt-Hess gradeⅢ-Ⅳ,hypertension and epilepsy were high risk factors for rebleeding in SAH patients(P<0.05).Conclusion Aneurysm diameter≥10mm,modified Fisher gradeⅢ-Ⅳ,Hunt-Hess gradeⅢ-Ⅳ,hypertension and epilepsy are high risk factors for rebleeding in SAH patients.Relevant preventive measures should be taken to actively control rebleeding and improve the prognosis of patients.

关 键 词：蛛网膜下腔出血 再出血 高危因素 预防措施 

分 类 号：R743.35[医药卫生—神经病学与精神病学]