动脉瘤性蛛网膜下腔出血预后危险因素分析及临床意义

Prognostic risk factors of aneurysmal subarachnoid hemorrhage and their significances

目的:探讨动脉瘤性蛛网膜下腔出血(subarachnoid hemorrhage caused by intracranial aneurysms,aSAH)各危险因素与临床预后相关性,为临床诊治提供参考依据。方法:收集本院神经内科2007年1月-2009年12月经临床确诊为aSAH的87例患者临床资料,分别对aSAH患者的一般资料、动脉瘤的特征及APACHEⅡ评分等危险因素进行统计分析。结果:单因素数据分析提示年龄、动脉瘤大小、是否多发、血压、脑血管痉挛、再次出血、Hunt-Hess分级、APACHEⅡ评分与临床预后呈显著相关性,多因素回归分析提示动脉瘤大小、脑血管痉挛、再次出血、Hunt-Hess分级、APACHEⅡ评分是aSAH预后独立危险因素。结论:患者高龄、脑血管痉挛、动脉瘤多发、再次出血、APACHEⅡ评分、Hunt-Hess分级与aSAH预后有显著相关性,重视这些指标的预测价值对降低患者病死率和残疾率具有重要参考意义。

Objective：To study risk factors of aneurysmal subarachnoid hemorrhage （subarachnoid hemorrhage caused by intracranial aneurysms, aSAH） and to explore their relationship with clinical prognosis in order to provide references in clinics. Methods：Clini-cal data of 87 cases of aSAH from January 2007 to December 2009 in department of neurology were collected and statistical analysis was made on patients＇ general information, characteristics of aneurysm and APACHE 1I scores. Results： Single factor analysis showed that patients＇ age, aneurysm size, multiple aneurysms or not, blood pressure, cerebral vasospasm, rebleeding, APACHE Ⅱ score, Hunt-Hess classification were significantly correlated with clinical prognosis. Log/st/c regression showed that aneurysm size,cerebral va-sospasm, rebleeding, APACHE Ⅱ score, Hunt-Hess classification were significantly correlated with prognosis of aSAH. Conclusions： Patients＇ aneurysm size, cerebral vasospasm, rebleeding, APACHE Ⅱ score and Hunt-Hess classification are significantly correlated with prognosis of aSAH;the predication of these indicators is of great importance in reducing mortality and morbidity of aSAH.