动脉瘤性蛛网膜下腔出血并发脑水肿的影响因素及预后分析  

Influencing factors and prognosis of aneurysmal SAH complicated with cerebral edema

作　　者：何茜[1] 樊朝凤[1] HE Qian;FAN Zhao-feng(General Department of Neurological Diseases,West China Hospital of Sichuan University,Chengdu 610000,China)

机构地区：[1]四川大学华西医院神经疾病综合病房,四川成都610000

出　　处：《河北医科大学学报》2024年第6期627-631,共5页Journal of Hebei Medical University

基　　金：四川省科技计划项目(2020YJ0033)。

摘　　要：目的 探讨影响动脉瘤性蛛网膜下腔出血(subarachnoid hemorrhage, SAH)并发脑水肿的危险因素,并对患者生存预后进行分析。方法 选取动脉瘤性SAH患者315例为研究对象,根据是否发生脑水肿将患者分为脑水肿组(n=78)及未发生脑水肿组(n=237),采用Logistic回归分析影响患者并发脑水肿的危险因素;根据改良Rankin评分(Modified Rankin Scale, mRS)将患者分为预后良好组(n=42)及预后不良组(n=36),采用Logistic回归分析影响患者预后不良的因素。结果 年龄≥60岁、颅内感染为动脉瘤性SAH并发脑水肿的独立危险因素(P<0.05);随访1年,36例患者预后不良,年龄、Hunt-Hess分级、CT Fisher分级、病灶数目为动脉瘤性SAH并发脑水肿患者预后不良的独立影响因素(P<0.05)。结论 高龄、颅内感染的动脉瘤性SAH患者应密切注意脑水肿的发生。对于高龄、Hunt-Hess分级Ⅲ~Ⅳ级、CT Fisher分级4级、病灶多发患者应关注预后情况,防止预后不良的发生。Objective To explore the risk factors and survival prognosis of aneurysmal subarachnoid hemorrhage(SAH)complicated with cerebral edema.Methods A total of 315 patients with aneurysmal SAH were enrolled as the research subjects,and they were divided into cerebral edema group(n=78)and non-cerebral edema group(n=237)according to occurrence of cerebral edema.Logistic regression analysis was used to analyze risk factors for cerebral edema in patients with aneurysmal SAH.The patients were divided into favourable prognosis group(n=42)and poor prognosis group(n=36)according to modified Rankin scale(mRS)score,and the factors affecting the poor prognosis of patients was analyzed by logistic regression analysis.Results Age≥60 years and intracranial infection were independent risk factors for cerebral edema in patients with aneurysmal SAH(P<0.05).After 1-year follow-up,36 patients had poor prognosis.Age,Hunt Hess grade,CT Fisher grade,and number of lesions were independent influencing factors for poor prognosis in patients with aneurysmal SAH complicated with cerebral edema(P<0.05).Conclusion Aneurysmal SAH patients with advanced age and intracranial infection should pay close attention to the occurrence of cerebral edema.For elderly patients with Hunt-Hess gradeⅢ-Ⅳ,CT Fisher grade 4,and multiple lesions,clinicians should pay attention to the prognosis of patients and prevent the occurrence of poor prognosis.

关 键 词：蛛网膜下腔出血 脑水肿 危险因素 

分 类 号：R743.35[医药卫生—神经病学与精神病学]