动脉瘤病人术后并发认知机能障碍的影响因素

Causing and influential factor investigation of cognitive dysfunction in postoperative ruptured aneurysm

目的 认知机能障碍是动脉瘤破裂后使病人失能的常见后遗症，故探讨动脉瘤破裂病人术后出现认知机能障碍原因及影响因素。方法 回顾性研究动脉瘤破裂手术治疗病人22例。参考病人术前Hunt—Hess分级，SAH Fisher评分及动脉瘤部位，探讨其与病人发生认知机能障碍的关系。结果 并发认知障碍8例；其中前交通动脉瘤表现为5例，左侧后交通动脉瘤2例，左侧大脑中动脉瘤1例。SAH Fisher评分3分6例，2分2例。发病时间：术后8～10d出现5例，14～16d2例，1例病人术后18d发病（已出院）。结论 结果表明，动脉瘤破裂手术病人并发认知功能障碍由多种综合因素导致。临床应早期重视病人术后认知功能障碍的防治，降低病人持久性认知机能障碍发病率，促进病人生活自理和社会活动参与能力。

Objective Further investigate the causing and influential factor of patients who generated cognitive dysfunction in postoperative ruptured aneurysm. Methods 22 operative ruptured aneurysms patients were retrospectively evaluated the relationship of patients＇ cognitive dysfunction with the preoperative Hunt-Hess grade, SAH Fisher score and the location of aneurysm. MMSE were used to screening and ascertainment cognitive dysfunction. Results Patients manifest with cognitive dysfunction in 8 cases. Anterior communicating aneurysms in 5 cases, posterior communicating aneurysms in 2 cases, Left middle artery in 1 case, and SAH Fisher 3 score in 6 cases and 2 score in 2 cases. 8-10 days after operation onset in 5 cases, 14-16 days in 2 cases, and 1 cases onset in 18 days after check out. most patients showed mood disturbance, speech nonverbal memory and mental activity speed dysfunction. Conclusions Study showed that cognitive dysfunction were caused by multi factor in postoperative ruptured aneurysm patients. We should highly think of the treatment strategies aimed at reducing cognitive dysfunction early after the operation, cut down patient＇ permanent mood disturbance, enhance the independence and self-care, the capability of participate to the social activities.