蛛网膜下腔出血合并脑室出血的临床分析

Clinical analysis of subarachnoid hemorrhage concurrent with intraventricular hemorrhage

目的:从临床方面分析蛛网膜下腔出血(SAH)合并脑室出血(IVH)的临床特点。方法:回顾性分析100例SAH患者,其中,SAH合并IVH 64例(SAH合并IVH组),SAH不合并IVH 36例(单纯SAH组),比较分析两组的头颅CT及临床表现。结果:①SAH合并IVH组,男占39.1%,女占60.9%,单纯SAH组,男占66.7%,女占33.3%,两组性别比较,差异有统计学意义(P<0.05);②SAH合并IVH组较单纯SAH组易再发出血,差异有高度统计学意义(P<0.01);③SAH合并IVH组较单纯SAH组去脑强直性抽搐发生率高,差异有高度统计学意义(P<0.01);④SAH合并IVH组较单纯SAH组视神经乳头水肿及玻璃膜下出血发生率高,差异有统计学意义(P<0.05);⑤SAH合并IVH组较单纯SAH组临床病情较重,大多数在Hunt-Hess分级Ⅲ级以上,差异有统计学意义(P<0.05);⑥SAH合并IVH组较单纯SAH组易并发颅内血肿及急性期脑积水,差异有高度统计学意义(P<0.01);⑦SAH合并IVH组(死亡率为51.6%)预后较单纯SAH组(8.3%)差,差异有统计学意义(P<0.05)。结论:SAH并IVH患者多好发于女性,综合评价病情较重,并发症较多,临床医生应积极实施合理的治疗方法。

Objective： To analyze the clinical characteristics of subarachnoid hemorrhage （SAH） concurrent with intraventricular hemorrhage （IVH） from clinical aspects. Methods： 100 patients with SAH were analyzed retrospectively. Brain CT and clinical manifestations were analyzed comparatively to 64 patients with SAH and IVH（SAH and IVH group） and 36 patients with only SAH （SAH group）. Results： ①The gender of SAH and IVH group （male 39.1%, female 60.9%） was compared with SAH group （66.7%, 33.3%）, there was a significant difference （P〈0.05）. ②Hemorrhage relapse of SAH and IVH group was easier than SAH group, there was a significant difference （P〈0.01）. ③The prevalence of decerebrate rigidity type convulsions of SAH and IVH group was higher than SAH group, there was a significant difference （P〈0.01）; ④The prevalence of papilledema and glass membrane hemorrhage of SAH and IVH group was higher than SAH group, there was a significant difference （P〈0.05）.⑤Clinical conditions of SAH and IVH group were more serious than SAH group, most of which were above grade Ill of Hunt-Hess grading, and there was a significant difference （P〈0.05）. ⑥Patients with SAH and IVH were more likely to have acute hydrocephalus than SAH group, there was a significant difference （P〈0.01）. ⑦Prognosis of SAH and IVH group （mortality rate 51.6%） was worse than SAH group（8.3%）, there was a significant difference （P〈0.05）. Conclusion： SAH concurrent with IVH is more common in female. Comprehensive evaluation indicates is more serious conditions and more complication. Therefore, it is vital for clinicians to implement reasonable treatment.