动脉瘤性蛛网膜下腔出血后发生慢性脑积水的危险因素分析

Factors Related to Chronic Hydrocephalus after Aneurismal Subarachnoid Hemorrhage

目的探讨动脉瘤性蛛网膜下腔出血后发生慢性脑积水的危险因素。方法回顾性分析2002年1月至2011年1月淄博市妇幼保健院所收治的动脉瘤性蛛网膜下腔出血患者的临床资料,比较出血后发生(慢性)脑积水患者与非脑积水患者在性别、年龄、吸烟史、饮酒史、高血压病史、出血是否破入脑室、动脉瘤所在位置等9个相关指标上有无差异。采用Logistic回归模型分析动脉瘤性蛛网膜下腔出血后发生慢性脑积水的危险因素。结果 676例中发生(慢性)脑积水129例,发生率为19.1%。发生脑积水患者及未发生脑积水患者在年龄、高血压病史、出血破入脑室率、动脉瘤位置、Fisher及Hunt-Hess级别6个指标上均有统计学意义(P<0.05)。影响慢性脑积水发生的Logistic回归分析显示,出血破入脑室、有高血压病史及Fisher和Hunt-Hess级别高是导致脑积水发生的独立危险因素(P<0.05)。结论动脉瘤性蛛网膜下腔出血后有约19.1%的患者发生慢性脑积水,这些患者常合并高血压、出血破入脑室等特殊情况,临床医师可根据高危因素提早进行预防处理。

Objective To study the factors related to chronic hydrocephalus after aneurismal subarachnoid hemorrhage.Methods Clinical data of cerebral trauma patients who were treated at our hospital from Jan.2002 to Jan.2011 was retrospectively analyzed.They were divided into hydrocephalus group and nonhydrocephalus according to having hydrocephalus or not.9 indicators including gender,age,smoking history,drinking history,hypertension history,if hemorrhage into ventricle occurs,and location of the aneurysm were compared.Logistic regression model was adopted for analysis of the risk factors for chronic hydrocephalus after aneurysmal subarachnoid hemorrhage.Results The incidence of（chronic） hydrocephalus was 19.1%（129/676）.Differences in age,hypertension history,intraventricular hemorrhage,aneurysm location,Fisher and Hunt-Hess grade between the patients with hydrocephalus and patients without hydrocephalus were statically significant（P 0.05）.Logistic regression analysis showed that the risk factors included hypertension,presence of intraventricular hemorrhage,high Hunt-Hess grade,and high Fisher grade（P 0.05）.Conclusion The incidence rate of chronic hydrocephalus is 19.1%,the patients are often combined with situations of hypertension and presence of intraventricular hemorrhage,in which cases the clinicians should take preventive measures according to the risk factors.