动脉瘤性蛛网膜下腔出血患者认知功能障碍的影响因素  

The influencing factors of cognitive dysfunction in patients with aneurysmal subarachnoid hemorrhage

作　　者：谢兵[1] 韩昊锦 李锐韬 丁明祥[1] 韩志安[1] Xie Bing;Han Haojin;Li Ruitao;Ding Mingxiang;Han Zhian(Department of Cerebrovascular Intervention,Zhongshan People's Hospital,Zhongshan,Guangdong 528400,China)

机构地区：[1]中山市人民医院脑血管介入科,广东中山528400

出　　处：《中国微侵袭神经外科杂志》2025年第2期83-86,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：广东省中山市医学科研基金(编号:20241A020002)。

摘　　要：目的探讨动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)患者认知功能障碍的影响因素。方法回顾性分析268例aSAH患者的临床资料,均在入院24h内完成血管内介入手术。术后6个月及12个月,采用蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评价认知功能。根据患者有无认知功能障碍,将患者分为障碍组和正常组。比较两组术前临床资料,分析影响认知功能障碍的相关因素。结果术后6个月存在认知功能障碍患者112例(41.79%),术后12个月仍存在认知功能障碍患者53例(19.78%)。随着术后时间延长,患者认知功能障碍发生率逐渐降低。统计分析显示:术前Hunt-Hess分级>Ⅲ级,改良Fisher分级>Ⅱ级,合并脑梗死、脑积水是aSAH患者认知功能障碍的独立影响因素。结论aSAH患者认知障碍发生率较高。术前Hunt-Hess分级高,改良Fisher分级高,合并脑梗死、脑积水的aSAH患者,可能更容易出现认知功能障碍。临床上合并上述高危因素者,应该及早识别并进行临床干预,以期改善认知功能障碍。Objective To investigate the influential factors of cognitive dysfunction in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods The clinical data of 268 patients with aSAH were analyzed retrospectively.Cognitive function was evaluated using the Montreal Cognitive Assessment(MoCA)at 6 and 12 months after onset,and the relevant factors affecting cognitive dysfunction were analyzed based on the presence or absence of cognitive impairment.Results There were 112 patients(41.79%)with cognitive dysfunction at postoperative 6 months and 53 patients(19.78%)with cognitive dysfunction at 12 months postoperatively.With the prolongation of postoperative time,the incidence of cognitive dysfunction gradually decreased.Statistical analysis showed that the preoperative Hunt-Hess grade>Ⅲ,the modified Fisher grade>Ⅱ,combined cerebral infarction and hydrocephalus were the influential factors of cognitive dysfunction in patients with aSAH.Conclusions The incidence of cognitive impairment is relatively high in aSAH patients.Patients with high preoperative Hunt-Hess grade,modified Fisher grade,cerebral infarction,and hydrocephalus aSAH may be more likely to have cognitive dysfunction.Patients with the above high-risk factors should be identified and clinically intervened as soon as possible to improve cognitive dysfunction.

关 键 词：颅内动脉瘤 蛛网膜下腔出血 认知功能障碍 影响因素 

分 类 号：R651.12[医药卫生—外科学]