中国现代医学杂志2017，Vol.27Issue(26)：114-118,5.DOI:10.3969/j.issn.1005-8982.2017.26.024
动脉瘤性蛛网膜下腔出血后迟发性脑缺血的危险因素及预后研究
Study of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage
马修尧 1王荣 1任超 1王强 1刘彬 1向欣 2杨华2
作者信息
- 1. 安徽省宿州市第一人民医院脑血管病诊疗中心,安徽宿州234000
- 2. 贵州医科大学神经外科,贵州贵阳550001
- 折叠
摘要
Abstract
Objective To investigate the risk factors and prognosis of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.Methods Sixty patients with delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage were enrolled into delayed ischemic cerebral ischemia group,and 210 cases of patients without delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage were treated as nondelayed cerebral ischemia group in our hospital.The clinical data of both groups were collected.Results There were statistical differences in cerebral edema,timing of surgery,aneurysm position,WFNS grade,HuntHess grade,improved Fisher grade,hypoalbuminemia,hypohemoglobinemia and hyponatremia between the delayed cerebral ischemia group and the non-delayed cerebral ischemia group (P ＜ 0.05).There was no significant difference in gender,age,diabetes mellitus or hypertension between the two groups (P ＞ 0.05).Logistic regression analysis showed that WFNS grade ≥ Ⅳ,Hunt-Hess grade ≥ Ⅲ,improved Fisher grade ≥ Ⅲ,hypoalbuminemia and hyponatremia were the independent risk factors of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage (P ＜ 0.05).There was significant difference in prognosis between the delayed cerebral ischemia group and the non-delayed cerebral ischemia group (P ＜ 0.05).The moderate disability plus recovery rate of the delayed cerebral ischemia group was lower than that of the non-delayed cerebral ischemia group.The rate of patients in vegetative state plus severe disability and the mortality in the delayed cerebral ischemia group were higher than those in the non-delayed cerebral ischemia group.Conclusions WFNS grade ≥ Ⅳ,Hunt-Hess grade ≥ Ⅲ,improved Fisher grade ≥ Ⅲ,hypoalbuminemia and hyponatremia are the independent risk factors of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.The prognosis of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage is poor.关键词
动脉瘤/蛛网膜下腔出血/迟发性脑缺血/危险因素/预后Key words
aneurysm/subarachnoid hemorrhage/delayed cerebral ischemia/risk factor/prognosis分类
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马修尧,王荣,任超,王强,刘彬,向欣,杨华..动脉瘤性蛛网膜下腔出血后迟发性脑缺血的危险因素及预后研究[J].中国现代医学杂志,2017,27(26):114-118,5.
