动脉瘤性蛛网膜下腔出血患者Hunt-Hess分级与并发症及功能障碍相关性分析  

Correlation Analysis of Hunt-Hess Grading with Complications and Dysfunction in Patients with Aneurysmal Subarachnoid Hemorrhage

作　　者：郭鸣[1,2] 李冰洁[1,2] 梅利平[1,2] 赵军[1,2] 周昊[1,2] GUO Ming;LI Bingjie;MEI Liping;ZHAO Jun;ZHOU Hao(China Rehabilitation Research Center,Beijing 10086,China;School of Rehabilitation Medicine,Capital Medical University,Beijing 10086,China)

机构地区：[1]中国康复研究中心,北京100068 [2]首都医科大学康复医学院,北京100068

出　　处：《神经损伤与功能重建》2024年第4期217-221,共5页Neural Injury and Functional Reconstruction

基　　金：国家重点研发计划(中国老年失能预防与干预管理网络及技术研究,No.2020YFC2008500;老年失能综合康复评估及管理模式研究,No.2020YFC2008502)。

摘　　要：目的:探讨动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)患者的Hunt-Hess分级与并发症及神经系统功能障碍的相关性。方法:回顾性分析2011年10月到2021年10月收治的195例aSAH患者的临床资料,将Hunt-HessⅠ~Ⅲ级纳入低级别组(86例),Ⅳ~Ⅴ级纳入高级别组(109例)。比较2组患者的一般情况、量表评分、并发症及主要功能障碍,并将差异有统计学意义的指标进行多因素Logistic回归分析。结果:Hunt-Hess分级与脑积水(OR 2.850、95%CI 1.560~5.206),运动功能障碍(OR 3.522、95%CI 2.026~6.121),语言功能障碍(OR 1.928、95%CI 1.062~3.500),意识障碍(OR 3.662、95%CI 1.558~8.607),吞咽障碍(OR 2.383、95%CI 1.248~4.550)呈正相关;与年龄(OR 0.970、95%CI 0.945~0.996),继发脑梗死(OR 0.414、95%CI 0.227~0.754),Fugl-Meyer平衡评分(OR 0.890、95%CI 0.818~0.968),ADL评分(OR 0.983、95%CI 0.971~0.994)呈负相关。结论:Hunt-Hess高级别组的患者脑积水的发生比率更高,整体功能障碍更重,年轻患者的存活率更高;但Hunt-Hess级别高低,患者均有认知障碍的风险,应注意及时筛查并进行个体化康复。Objective:To explore the correlation between Hunt-Hess grading and complications as well as neurological dysfunction in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods:Clinical data of 195 aSAH patients treated from October 2011 to October 2021 were retrospectively analyzed.Patients graded I-III on the Hunt-Hess scale were included in the low-grade group(86 cases),and those graded IV-V were included in the high-grade group(109 cases).General conditions,scale scores,complications,and main dysfunctions of patients in both groups were compared,and indicators with significant differences were analyzed using multivariate logistic regression.Results:The Hunt-Hess grading was positively correlated with hydrocephalus(OR 2.850,95%CI 1.560-5.206),motor dysfunction(OR 3.522,95%CI 2.026-6.121),language dysfunction(OR 1.928,95%CI 1.062-3.500),consciousness disorder(OR 3.662,95%CI 1.558-8.607),and swallowing disorder(OR 2.383,95%CI 1.248-4.550);it was negatively correlated with age(OR 0.970,95%CI 0.945-0.996),secondary cerebral infarction(OR 0.414,95%CI 0.227-0.754),Fugl-Meyer balance score(OR 0.890,95%CI 0.818-0.968),and ADL score(OR 0.983,95%CI 0.971-0.994).Conclusion:Patients in the high-grade Hunt-Hess group have a higher incidence of hydrocephalus and more severe overall dysfunction,while younger patients have a higher survival rate;however,regardless of the level of Hunt-Hess grade,patients are at risk of cognitive disorders.Timely screening and individualized rehabilitation should be considered.

关 键 词：动脉瘤性蛛网膜下腔出血 HUNT-HESS分级 并发症 功能障碍 脑积水 

分 类 号：R741[医药卫生—神经病学与精神病学] R743.34[医药卫生—临床医学]