动脉瘤性蛛网膜下腔出血患者发生昏迷的影响因素研究  

Study on influencing factors of coma in patients with aneurysmal subarachnoid hemorrhage

作　　者：黄永华 唐剑锋 HUANG Yong-hua;TANG Jian-feng(Department of Neurosurgery,The First People's Hospital of Shaoguan City,Shaoguan 512000,China)

机构地区：[1]韶关市第一人民医院神经外科,512000

出　　处：《中国实用医药》2025年第5期36-39,共4页China Practical Medicine

摘　　要：目的研究动脉瘤性蛛网膜下腔出血患者发生昏迷的影响因素。方法收集50例动脉瘤性蛛网膜下腔出血患者的临床资料,分析患者昏迷发生情况,并采用单因素及多因素分析动脉瘤性蛛网膜下腔出血患者发生昏迷的影响因素。结果50例患者入院后有22例(44.00%)患者发生昏迷,设为昏迷组;28例(56.00%)患者未发生昏迷,设为未昏迷组。单因素分析显示,昏迷组患者的年龄为(62.4±8.5)岁,Hunt-Hess分级Ⅰ级1例、Ⅱ级4例、Ⅲ级5例、Ⅳ级12例、Ⅴ级0例,Fisher分级Ⅰ级1例、Ⅱ级3例、Ⅲ级3例、Ⅳ级15例、Ⅴ级0例,动脉瘤直径为(7.8±1.3)mm,脑积水10例,血管痉挛9例;未昏迷组的年龄为(54.7±6.0)岁,Hunt-Hess分级Ⅰ级13例、Ⅱ级10例、Ⅲ级4例、Ⅳ级1例、Ⅴ级0例,Fisher分级Ⅰ级12例、Ⅱ级6例、Ⅲ级7例、Ⅳ级3例、Ⅴ级0例,动脉瘤直径为(6.8±1.6)mm,脑积水3例,血管痉挛2例。两组患者的年龄、Hunt-Hess分级、Fisher分级、动脉瘤直径、脑积水占比和血管痉挛占比对比差异显著(P<0.05)。多因素分析显示,年龄、Hunt-Hess分级、Fisher分级、动脉瘤直径、脑积水和血管痉挛是动脉瘤性蛛网膜下腔出血患者发生昏迷的影响因素(P<0.05)。结论动脉瘤性蛛网膜下腔出血患者发生昏迷的影响因素较多,如年龄、Hunt-Hess分级、Fisher分级、动脉瘤直径、脑积水和血管痉挛,因此临床需加强对影响因素的关注,并实施有效的干预手段,降低昏迷发生的风险。Objective To study the influencing factors of coma in patients with aneurysmal subarachnoid hemorrhage.Methods The clinical data of 50 patients with aneurysmal subarachnoid hemorrhage were collected to analyze the occurrence of coma,and the influencing factors of coma in patients with aneurysmal subarachnoid hemorrhage were analyzed by univariate and and multivariate analysis.Results After admission,22(44.00%)of the 50 patients had coma and were classified as coma group;28 patients(56.00%)did not have coma and were classified as non-coma group.Univariate analysis showed that the age of the patients in the coma group was(62.4±8.5)years;1 case in Hunt-Hess gradeⅠ,4 cases in gradeⅡ,5 cases in gradeⅢ,12 cases in gradeⅣand 0 cases in gradeⅤ;1 case in Fisher gradeⅠ,3 cases in gradeⅡ,3 cases in gradeⅢ,15 cases in gradeⅣand 0 cases in gradeⅤ;the aneurysm diameter was(7.8±1.3)mm,with 10 cases of hydrocephalus and 9 cases of vasospasm.In the non-coma group,the age was(54.7±6.0)years old;13 cases in Hunt-Hess gradeⅠ,10 cases in gradeⅡ,4 cases in gradeⅢ,1 case in gradeⅣand 0 cases in gradeⅤ;12 cases in Fisher gradeⅠ,6 cases in gradeⅡ,7 cases in gradeⅢ,3 cases in gradeⅣand 0 cases in gradeⅤ;the aneurysm diameter was(6.8±1.6)mm,with 3 cases of hydrocephalus and 2 cases of vasospasm.There were significant differences in age,Hunt-Hess grading,Fisher grading,aneurysm diameter,and percentage of hydrocephalus and percentage of vasospasm between the two groups(P<0.05).Multivariate analysis showed that age,Hunt-Hess grading,Fisher grading,aneurysm diameter,hydrocephalus and vasospasm were influential factors in the occurrence of coma in patients with aneurysmal subarachnoid hemorrhage(P<0.05).Conclusion There are many influencing factors for coma in patients with aneurysmal subarachnoid hemorrhage,such as age,Hunt-Hess grading,Fisher grading,aneurysm diameter,hydrocephalus and vasospasm.Therefore,clinical attention to these influencing factors needs to be strengthened,and effective interven

关 键 词：动脉瘤 蛛网膜下腔出血 昏迷 影响因素 

分 类 号：R65[医药卫生—外科学]