动脉瘤性蛛网膜下隙出血致急性脑积水患者出院6个月后的预后状况及其影响因素  

Prognosis of patients with acute hydrocephalus caused by aneurysmal subarachnoid hemorrhage after six months of discharge and its influencing factors

作　　者：周武涛[1] 黄志刚 孙涛 吕海欣 ZHOU Wu-tao;HUANG Zhi-gang;SUN Tao;LV Hai-xin(Department of Neurosurgery,Zhengzhou People's Hospital,Zhengzhou 450003,Henan,CHINA)

机构地区：[1]郑州人民医院神经外科,河南郑州450003

出　　处：《海南医学》2024年第19期2764-2767,共4页Hainan Medical Journal

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20191070)。

摘　　要：目的探讨动脉瘤性蛛网膜下隙出血(aSAH)致急性脑积水患者出院6个月后的预后状况及其影响因素。方法回顾性分析2022年1月至2024年1月郑州人民医院神经外科收治的110例a SAH后急性脑积水患者的病历资料,所有患者出院6个月后均采用改良的Rankin量表(mRS)评分评估患者的预后,mRS评分>2分为预后不良,m RS评分≤2分为预后良好,将出院后6个月预后不良的25例作为预后不良组,预后良好的85例作为预后良好组。比较两组患者的年龄、性别、吸烟史、饮酒史、糖尿病史、高血压史、动脉瘤位置、动脉瘤直径、发病至手术时间、手术方式、分流依赖性脑积水、迟发性脑缺血、颅内出血等临床资料。采用Logistic回归分析影响a SAH后急性脑积水出院6个月后预后的危险因素。结果两组患者的年龄、性别、吸烟史、饮酒史、糖尿病史、高血压史、动脉瘤位置、动脉瘤直径、发病至手术时间、手术方式比较差异均无统计学意义(P>0.05);预后不良组患者的分流依赖性脑积水、迟发性脑缺血、颅内出血的占比分别为60.00%、68.00%、64.00%,明显高于预后良好组的23.53%、29.41%、25.88%,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,分流依赖性脑积水、迟发性脑缺血、颅内出血均是影响a SAH后急性脑积水出院6个月后预后的危险因素(P<0.05)。结论a SAH致急性脑积水患者出院6个月后的预后状况良好,分流依赖性脑积水、迟发性脑缺血、颅内出血均是影响aSAH致急性脑积水患者出院6个月后预后的危险因素。Objective To investigate the prognosis and influencing factors of acute hydrocephalus caused by aneurysmal subarachnoid hemorrhage(aSAH)after discharge for six months.Methods The medical records of 110 patients with acute hydrocephalus caused by aSAH admitted to Zhengzhou People's Hospital from January 2022 to January 2024 were retrospectively analyzed.The improved Rankin Scale(mRS)score was used to evaluate the prognosis of all patients six months after discharge:mRS score>2 was classified as poor prognosis,and mRS score≤2 was classified as good prognosis.Among the 110 patients,25 with poor prognosis at six months after discharge were enrolled as the poor prognosis group,and 85 patients with good prognosis at six months after discharge were enrolled as the good prognosis group.Age,sex,smoking history,drinking history,diabetes history,hypertension history,aneurysm location,aneurysm diameter,time from onset to operation,operation mode,shunt dependent hydrocephalus,delayed cerebral ischemia,and intracranial hemorrhage were compared between the two groups.Logistic regression was used to analyze the risk factors affecting the prognosis of patients with acute hydrocephalus after aSAH at six months of discharge.Results There was no significant difference in age,sex,smoking history,drinking history,diabetes history,hypertension history,aneurysm location,aneurysm diameter,time from onset to operation,and operation method between the two groups(P>0.05).The proportions of shunt dependent hydrocephalus,delayed cerebral ischemia,and intracranial hemorrhage in the poor prognosis group were 60.00%,68.00%,and 64.00%,which were significantly higher than 23.53%,29.41%,and 25.88%in the good prognosis group(P<0.05).Logistic regression analysis showed that shunt dependent hydrocephalus,delayed cerebral ischemia,and intracranial hemorrhage were all risk factors affecting the prognosis of patients with acute hydrocephalus after aSAH at six months after discharge(P<0.05).Conclusion The prognosis of patients with acute hydrocephalus c

关 键 词：动脉瘤性蛛网膜下隙出血 急性脑积水 改良的Rankin量表 危险因素 

分 类 号：R732.21[医药卫生—肿瘤]