CAJ | 학술논문

目的描述蛛网膜下腔出血(SAH)患者生存状况,探讨死亡的相关危险因素.方法对174例患者的年龄、既往史、出血累及脑区、实验室检查指标、治疗方式、并发症与预后等进行随访调查,通过Kaplan-Meier生存分析和Cox比例风险模型分析,明确患者生存状况及死亡的相关危险因素.结果共164例患者完成随访调查[失访10例(5.75%)],其中死亡66例,最长随访时间为5.64年;患者28天生存率70.60%,1年生存率63.40%,3～5年生存率57.20%;应用尼膜同、行动脉瘤夹闭和栓塞治疗可以显著降低患者的死亡风险;而高龄、长期吸烟、低钠血症、急性期白细胞增高、再出血和脑血管痉挛等将显著增加患者的死亡风险.结论高龄、急性期白细胞增高、并发低钠血症、消化道出血、再出血和脑血管痉挛的SAH患者预后不良;给予尼膜同、行动脉瘤夹闭或栓塞治疗可以降低动脉瘤性SAH患者的死亡风险.
목적 묘술주망막하강출혈(SAH)환자생존상황,탐토사망적상관위험인소.방법 대174례환자적년령、기왕사、출혈루급뇌구、실험실검사지표、치료방식、병발증여예후등진행수방조사,통과Kaplan-Meier생존분석화Cox비례풍험모형분석,명학환자생존상황급사망적상관위험인소.결과 공164례환자완성수방조사[실방10례(5.75%)],기중사망66례,최장수방시간위5.64년;환자28천생존솔70.60%,1년생존솔63.40%,3～5년생존솔57.20%;응용니막동、행동맥류협폐화전새치료가이현저강저환자적사망풍험;이고령、장기흡연、저납혈증、급성기백세포증고、재출혈화뇌혈관경련등장현저증가환자적사망풍험.결론 고령、급성기백세포증고、병발저납혈증、소화도출혈、재출혈화뇌혈관경련적SAH환자예후불량;급여니막동、행동맥류협폐혹전새치료가이강저동맥류성SAH환자적사망풍험.
Objective To describe the survival state and to investigate the risk factors of death on patients with subarachnoid hemorrhage (SAH). Methods Age, past history, number of encephalic region suffering SAH, laboratory examination indexes, therapeutic measures, complications and prognosis of 174 patients with SAH were followed-up and investigated. The survival states and risk factors of death of the patients with SAH were identified by both Kaplan-Meicr survival analysis and Cox proportional risk model. Results There were 10 patients (5.75%) losing follow-up investigation and 164 patients with SAH completed the follow-up investigation. 66 patients died and the longest follow-up invcstigation time was 5.64 years. The survival rates of 28 days, 1 year and 3-5 years were 70.60%,63.40% and 57.20% respectively. The treatment of nimotop, aneurysm occlusion treatment and aneurysm embolotherapy could decrease the death of SAH. At the same time, advanced age, the long time smoking, hyponatremia, the rising of leucocyte in acute stage, repeated hemorrhage and cerebral angio spasm were the independent risk factors to the death of patients. Conclusion Prognosis of patients with advanced age, the rising of leucocyte in acute stage, gastrointestinal blooding, hyponatremia, repeated hemorrhage and cerebral angio spasm were unfavorable. When giving patients with aneurysm, the aneurysm occlusion and embolotherapy and nimotop treatment, the death risk could be reduced.