中国急救医学
中國急救醫學
중국급구의학
CHINESE JOURNAL OF CRITICAL CARE MEDICINE
2010年
4期
297-300
,共4页
钱进先%李磊%虞正权%陆士奇%汪利宗%孙海伟
錢進先%李磊%虞正權%陸士奇%汪利宗%孫海偉
전진선%리뢰%우정권%륙사기%왕리종%손해위
蛛网膜下腔出血%动脉瘤%预后%多因素分析
蛛網膜下腔齣血%動脈瘤%預後%多因素分析
주망막하강출혈%동맥류%예후%다인소분석
Subarachnoid hemorrhage%Aneurysm%Prognosis%Multivariate analysis
目的 探讨影响动脉瘤性蛛网膜下腔出血患者早期预后的危险因素.方法 回顾性分析苏州大学附属第一人民医院脑外科2007～2009年收治的152例颅内动脉瘤性蛛网膜下腔出血患者的临床资料,分别对年龄、高血压、意识障碍史、Hunt-Hess分级、改良Fisher分级等23项危险因素进行单因素分析,并进行Logistic回归分析.结果 单因素分析显示,Hunt-Hess分级、改良Fisher分级、格拉斯哥昏迷评分(GCS)、急性生理及慢性健康状况评分Ⅱ(APACHEⅡ)、简化急性生理学评分(SAPSⅡ)、脑血管痉挛、意识障碍史、高血压、年龄、白细胞计数、超敏C反应蛋白与预后有显著相关性(P<0.01或P<0.05).多因素Logistic回归分析显示,改良Fisher分级[OR=19.51,95%可信区间(CI)1.84～206.73,P=0.014]、APACHEⅡ评分[OR=17.34,95%CI 2.53～119.06,P=0.004]、脑血管痉挛[OR=27.84,95%CI 2.17～357.19,P=0.001]进入回归方程.结论 改良Fisher分级、APACHEⅡ评分、脑血管痉挛是动脉瘤性蛛网膜下腔出血早期预后不良的独立危险因素.
目的 探討影響動脈瘤性蛛網膜下腔齣血患者早期預後的危險因素.方法 迴顧性分析囌州大學附屬第一人民醫院腦外科2007～2009年收治的152例顱內動脈瘤性蛛網膜下腔齣血患者的臨床資料,分彆對年齡、高血壓、意識障礙史、Hunt-Hess分級、改良Fisher分級等23項危險因素進行單因素分析,併進行Logistic迴歸分析.結果 單因素分析顯示,Hunt-Hess分級、改良Fisher分級、格拉斯哥昏迷評分(GCS)、急性生理及慢性健康狀況評分Ⅱ(APACHEⅡ)、簡化急性生理學評分(SAPSⅡ)、腦血管痙攣、意識障礙史、高血壓、年齡、白細胞計數、超敏C反應蛋白與預後有顯著相關性(P<0.01或P<0.05).多因素Logistic迴歸分析顯示,改良Fisher分級[OR=19.51,95%可信區間(CI)1.84～206.73,P=0.014]、APACHEⅡ評分[OR=17.34,95%CI 2.53～119.06,P=0.004]、腦血管痙攣[OR=27.84,95%CI 2.17～357.19,P=0.001]進入迴歸方程.結論 改良Fisher分級、APACHEⅡ評分、腦血管痙攣是動脈瘤性蛛網膜下腔齣血早期預後不良的獨立危險因素.
목적 탐토영향동맥류성주망막하강출혈환자조기예후적위험인소.방법 회고성분석소주대학부속제일인민의원뇌외과2007～2009년수치적152례로내동맥류성주망막하강출혈환자적림상자료,분별대년령、고혈압、의식장애사、Hunt-Hess분급、개량Fisher분급등23항위험인소진행단인소분석,병진행Logistic회귀분석.결과 단인소분석현시,Hunt-Hess분급、개량Fisher분급、격랍사가혼미평분(GCS)、급성생리급만성건강상황평분Ⅱ(APACHEⅡ)、간화급성생이학평분(SAPSⅡ)、뇌혈관경련、의식장애사、고혈압、년령、백세포계수、초민C반응단백여예후유현저상관성(P<0.01혹P<0.05).다인소Logistic회귀분석현시,개량Fisher분급[OR=19.51,95%가신구간(CI)1.84～206.73,P=0.014]、APACHEⅡ평분[OR=17.34,95%CI 2.53～119.06,P=0.004]、뇌혈관경련[OR=27.84,95%CI 2.17～357.19,P=0.001]진입회귀방정.결론 개량Fisher분급、APACHEⅡ평분、뇌혈관경련시동맥류성주망막하강출혈조기예후불량적독립위험인소.
Objective To investigate the factors related to the prognosis in the patients with aneurysmal subarachnoid hemorrhage(aSAH). Methods The clinical data of 152 patients with aSAH, who were treated in the department of neurosurgery of our hospital from 2007 to 2009, were analyzed retrospectively. Univariate analysis was performed in age, hypertension, consciousness disorders, Hunt-Hess grade, modified Fisher grade and the other factors. Logistic multivariate analysis of the factors related to the prognosis was performed in the patients with aSAH. Results In univariate analysis, Hunt-Hess grade, modified Fisher grade, GCS score, APACHEⅡ, SAPSⅡ, CVS, consciousness disorders, hypertension, age, white blood cell count and hs-CRP were related to prognosis(P<0.01 or P<0.05). In Logistic multivariate analysis , modified Fisher grade (OR=19.51,95%CI 1.84～206.73,P=0.014),APACHEⅡ(OR=17.34,95%CI 2.53～119.06,P=0.004) and CVS(OR=27.84,95%CI 2.17～357.19,P=0.001) entered equation. Conclusion The modified Fisher grade, APACHEⅡ and CVS are independent risk factors of aSAH for early prognosis.
