动脉瘤性蛛网膜下腔出血并发低钠血症的危险因素分析

Risk factors of aneurysmal subarachnoid hemorrhage complicated with hyponatremia

目的研究动脉瘤性蛛网膜下腔出血并发低钠血症的相关危险因素。方法回顾性分析2016年3月至2018年3月重庆医科大学附属永川医院神经外科收治的143例动脉瘤性蛛网膜下腔出血患者的临床资料,统计其低钠血症发生率,分析其发生低钠血症的危险因素。结果143例患者中发生低钠血症50例,发生率为34.97%;Fisher分级Ⅲ~Ⅳ级、Hunt-Hess分级Ⅲ~Ⅴ级、蛛网膜下腔出血次数≥2次、大脑前动脉或前交通动脉瘤破裂是动脉瘤性蛛网膜下腔出血并发低钠血症的危险因素(P<0.05);有无吸烟或饮酒史、不同年龄、不同动脉瘤治疗方式(手术夹闭或栓塞)、不同动脉瘤大小的患者间低钠血症发生率比较差异均未见统计学意义(P均>0.05)。结论Fisher分级Ⅲ~Ⅳ级、Hunt-Hess分级Ⅲ~Ⅴ级、出血次数≥2次、大脑前动脉或前交通动脉瘤破裂的蛛网膜下腔出血患者低钠血症发生率高,应加强其监测、预防及治疗。

Objective To study the risk factors of aneurysmal subarachnoid hemorrhage complicated with hyponatremia.Methods The clinical data of 143 patients with aneurysmal subarachnoid hemorrhage hospitalized by the Neurosurgery Department of Yongchuan Hospital Affiliated to Chongqing Medical University from March 2016 to March 2018 were retrospectively analyzed.And the incidence of hyponatremia of enrolled patients was statistically calculated to analyze the risk factors of hyponatremia.Results There were 50 cases of hyponatremia in the 143 patients,and incidence was 34.97%.Fisher gradeⅢ-Ⅳ,Hunt-Hess gradeⅢ-Ⅴ,subarachnoid hemorrhage occurrence≥2 times,anterior cerebral artery or anterior communicating artery aneurysm rupture were risk factors for hyponatremia in patients with aneurysmal subarachnoid hemorrhage(P<0.05).There was no statistically significant difference in the incidence of hyponatremia among patients with smoking and drinking history or not,different ages,different aneurysm treatments(surgical clipping or embolization),and different aneurysm sizes(P all>0.05).Conclusions Aneurysmal subarachnoid hemorrhage patients with Fisher gradeⅢ-IV,Hunt-Hess gradeⅢ-V,subarachnoid hemorrhage occurrence≥2 times,anterior cerebral artery or anterior communicating artery aneurysm rupture has a high incidence of hyponatremia,so the monitoring,prevention and treatment should be strengthened for them.