创伤性蛛网膜下腔出血后脑积水的发生及危险因素分析

Analysis for the incidence and risk factors of hydrocephalus after traumatic subarachnoid hemorrhage

目的探讨创伤性蛛网膜下腔出血(SAH)后脑积水的发生率及其发生的临床危险因素。方法回顾性分析301例创伤性SAH病人的临床资料,记录病人GCS评分、年龄、性别、去骨瓣减压术、SAH特征等因素,Logistic回归分析创伤性SAH后发生脑积水的独立危险因素。结果随访2个月,发生脑积水36例(11.96%)。Logistic回归分析表明:年龄、脑室内出血、SAH厚度和SAH分布是创伤性SAH后出现脑积水的独立危险预测因素;而性别、入院GCS评分、SAH部位、去骨瓣减压术与创伤性SAH后并发脑积水无明显关系。结论脑积水是创伤性SAH后的常见并发症,高龄、脑室出血、SAH严重程度是创伤性SAH后发生脑积水的高危因素。

Objective To explore the incidence of hydrocephalus and its risk factors after traumatic subarachnoid hemorrhage （SAIl）. Methods Clinical data of 301 patients with traumatic SAH were analyzed retrospectively. The factors such as GCS score, age, sex, decompressive craniectomy and features of SAH were recorded. The independent risk factors of hydrocephalus after traumatic SAH were evaluated by Logistic regression analysis. Results During a follow-up of 2 months, the hydrocephalus occurred in 36 cases （11.96%）. Logistic regression analysis showed that the age, intraventricular hemorrhage, thickness of SAH and distribution of SAH were the independent risk factors for patients with hydrocephalus after traumatic SAH. There was no significant relationship between hydrocephalus after traumatic SAH and the factors as sex, admission GCS scores, location of SAH and decompressive craniectomy. Conclusions Hydrocephalus is a frequent complication for patients with traumatic SAH. Advanced age, intraventricular hemorrhage and severity degree of SAH are the high risk factors for hydrocephalus after traumatic SAH.