动脉瘤性蛛网膜下腔出血后慢性脑积水

Chronic Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage

目的探讨动脉瘤性蛛网膜下腔出血后(aSAH)慢性脑积水的发生率及其易患因素。方法回顾性研究2003年1月至2005年9月我科aSAH病例221例,采用单因素及多因素统计方法分析与慢性脑积水发生的相关影响因素。结果慢性脑积水的发生率为12.7%(28/221)。经单因素分析显示,患者年龄、Hunt-Hess级别、Fisher级别、前交通动脉瘤、aSAH次数以及脑室内出血具有统计学意义;多因素logistic回归分析显示,Fisher级别、脑室内出血、aSAH次数、前交通动脉瘤具有统计学意义。结论慢性脑积水为aSAH后一较常见并发症,影响其发生的高危因素包括Fisher级别、脑室内出血、aSAH次数、前交通动脉瘤。对具上述危险因素的aSAH患者应注意跟踪随访,及时诊治。

Objective To explore the incidence of the chronic hydrocephalus after aneurysmal subarachnoid hemorrhage （aSAH） and the factors correlated with its development, Methods The clinical data of 221 patients with aSAH treated in our department from January 2000 to September 2005 were analyzed retrospectively. The factors that associated with the development of chronic hydrocephalus were statistically analyzed by single varialble and multiple variables analysis. Results The incidence of chronic hydrocephalus was 12.7% in 221 patients with aSAH. The single variable analysis showed that the factors related to the chronic hydrocephalus included patients＇ age, Hunt-Hess grade, Fisher grade, the time number of SAH, aneurysmal location and intraventricular hemorrhage. By multiple variables analysis showed that the factors related to the chronic hydrocephalus included Fisher grade, intraventricular hemorrhage, the time number of SAH and aneurysmal location. Conclusions The chronic hydrocephalus is a common complication after aSAH. The risk factors related to it include high Fisher grade, intraventricular hemorrhage, repeated SAH and aneurysm of anterior communication artery. More attention should be paid to the patients with the risk factors and they should be closely followed up for early diagnosis and therapy.