中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2014年
11期
1101-1103
,共3页
胡福广%王立群%李贺扬%闫启超%高明%罗长均
鬍福廣%王立群%李賀颺%閆啟超%高明%囉長均
호복엄%왕립군%리하양%염계초%고명%라장균
动脉瘤性蛛网膜下腔出血%迟发性脑缺血%危险因素%吸烟%低钠%Hunt-Hess分级
動脈瘤性蛛網膜下腔齣血%遲髮性腦缺血%危險因素%吸煙%低鈉%Hunt-Hess分級
동맥류성주망막하강출혈%지발성뇌결혈%위험인소%흡연%저납%Hunt-Hess분급
Aneurysmal subarachnoid hemorrhage%Delayed cerebral ischemia%Risk factors%Smoking%Hyponatremia%Hunt-Hess grading
目的 探讨动脉瘤性蛛网膜下腔出血后与迟发性脑缺血显著相关的危险因素,研究其发病规律.方法 回顾性分析蛛网膜下腔出血患者入院时各种临床特征和相关指标.根据是否发生迟发性脑缺血,进行单因素及多因素Logistic回归分析,揭示迟发性脑缺血的危险因素.结果 193例患者符合研究标准,其中66例发生迟发性脑缺血,发病率34.2％.单因素分析结果示:发病后晚期手术、吸烟史、心电图异常、低钠血症、GCS评分低、Hunt-Hess分级高和Fisher分级高的患者发生迟发性脑缺血的概率大(P＜0.05).多因素Logistic逐步回归分析发现:有吸烟史(OR =9.462,95％ CI:2.782,32.180)、低钠(OR=2 285,95％ CI:1.232,4 235)、Hunt-Hess分级高(OR =2.223,95％ CI:1.011,4 891)回归系数b＞0、OR ＞1,为预示迟发性脑缺血发生的独立危险因素(P＜0.05).结论 吸烟史、低钠血症、Hunt-Hess分级高为迟发性脑缺血的独立危险因素.
目的 探討動脈瘤性蛛網膜下腔齣血後與遲髮性腦缺血顯著相關的危險因素,研究其髮病規律.方法 迴顧性分析蛛網膜下腔齣血患者入院時各種臨床特徵和相關指標.根據是否髮生遲髮性腦缺血,進行單因素及多因素Logistic迴歸分析,揭示遲髮性腦缺血的危險因素.結果 193例患者符閤研究標準,其中66例髮生遲髮性腦缺血,髮病率34.2％.單因素分析結果示:髮病後晚期手術、吸煙史、心電圖異常、低鈉血癥、GCS評分低、Hunt-Hess分級高和Fisher分級高的患者髮生遲髮性腦缺血的概率大(P＜0.05).多因素Logistic逐步迴歸分析髮現:有吸煙史(OR =9.462,95％ CI:2.782,32.180)、低鈉(OR=2 285,95％ CI:1.232,4 235)、Hunt-Hess分級高(OR =2.223,95％ CI:1.011,4 891)迴歸繫數b＞0、OR ＞1,為預示遲髮性腦缺血髮生的獨立危險因素(P＜0.05).結論 吸煙史、低鈉血癥、Hunt-Hess分級高為遲髮性腦缺血的獨立危險因素.
목적 탐토동맥류성주망막하강출혈후여지발성뇌결혈현저상관적위험인소,연구기발병규률.방법 회고성분석주망막하강출혈환자입원시각충림상특정화상관지표.근거시부발생지발성뇌결혈,진행단인소급다인소Logistic회귀분석,게시지발성뇌결혈적위험인소.결과 193례환자부합연구표준,기중66례발생지발성뇌결혈,발병솔34.2％.단인소분석결과시:발병후만기수술、흡연사、심전도이상、저납혈증、GCS평분저、Hunt-Hess분급고화Fisher분급고적환자발생지발성뇌결혈적개솔대(P＜0.05).다인소Logistic축보회귀분석발현:유흡연사(OR =9.462,95％ CI:2.782,32.180)、저납(OR=2 285,95％ CI:1.232,4 235)、Hunt-Hess분급고(OR =2.223,95％ CI:1.011,4 891)회귀계수b＞0、OR ＞1,위예시지발성뇌결혈발생적독립위험인소(P＜0.05).결론 흡연사、저납혈증、Hunt-Hess분급고위지발성뇌결혈적독립위험인소.
Objective To study was aimed to explore the significant risk factors associated with delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.Methods Collect the chnical data about the patients with aneurysmal subarachnoid hemorrhage from July 2011 to July 2012 in Department of Neurosurgery,the Second Hospital of Hebei Medical University.Analysis the age,sex,smoking history,blood pressure on admission,aneurysm site,the size of the aneurysm,glasgow com a scale,Hunt-Hess classification,Fisher grade,treatment modalities,timing of surgery,blood glucose,potassium,sodium and other related indicators retrospectivly.Group patients depending on whether the delayed cerebral ischemia occured,analysis datas using univariate and multivariate Logistic regression,determine the correlation factors about delayed cerebral ischemia.Results One hundred and ninety-three patients met the study criteria,66 patients occured ddayed cerebral ischemia,the incidence rate is 34.2％.Univariate analysis show that later surgery,with smoking history,ECG abnormalities,hyponatremia,low Glasgow Coma Scale score,high Hunt-Hess grade and high modified Fisher grade has much probabity ty (P ＜ 0.05) of occurring delayed cerebral ischemia Multivariate Logistic regression analysis showed that:with smoking history(OR =9.462,95％ CI:2782,32 180),hyponatremia(OR =2285,95％ CI:1.232,4.235),high Hunt-Hess grade (OR =2223,95％ CI:1.011,4.891) regression coefficient b ＞0,OR ＞1,indicates an independent risk factor for delayed cerebral ischemia (P ＜ 0.05).Conclusion Smoking history,hyponatremia,high Hunt-Hess grade were independent risk factors for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.
