蛛网膜下腔出血患者脑血管痉挛危险因素分析

Analysis of the risk factors for cerebral vasospasm in patients with subarachnoid hemorrhage

目的探讨蛛网膜下腔出血(SAH)患者发生脑血管痉挛(CVS)的危险因素,为防治SAH后CVS提供依据。方法选择2018年5月至2020年5月许昌市中心医院收治的96例SAH患者为研究对象,依据是否发生CVS将患者分为SAH组(n=50)和SAH+CVS组(n=46),分析SAH患者发生CVS的危险因素。结果单因素分析结果显示,年龄、Fisher分级、Hunt-Hess分级、意识障碍、吸烟、高血压、白细胞计数、血钙水平与SAH患者发生CVS有关(P<0.05),而性别、饮酒、高血糖与SAH患者发生CVS无关(P>0.05)。Logistic回归分析显示,年龄>55岁、Fisher分级Ⅳ级、Hunt-Hess分级>Ⅲ级、意识障碍、高血压、白细胞计数>15×10^(9) L^(-1)、血钙<2.2 mmol·L^(-1)为SAH患者发生CVS的独立危险因素(P<0.05)。结论SAH后CVS具有较高的发生率,年龄较大、Fisher分级和Hunt-Hess分级高、意识障碍、高血压、白细胞计数高、血钙水平低为SAH患者发生CVS的独立危险因素,临床应针对CVS发生的危险因素制定相应的防治措施,以降低SAH患者CVS发生率,改善患者预后。

Objective To investigate the risk factors for cerebral vasospasm(CVS)in patients with subarachnoid hemorrhage(SAH),so as to provide evidence for the prevention and treatment of CVS after SAH.Methods A total of 96 SAH patients admitted to Xuchang Central Hospital from May 2018 to May 2020 were selected as the research subjects,and the patients were divided into SAH group(n=50)and SAH+CVS group(n=46)according to whether CVS occurred or not,and the risk factors for CVS in SAH patients were analyzed.Results The univariate analysis showed that the age,Fisher classification,Hunt-Hess classification,consciousness disorders,smoking,hypertension,white blood cell count,and blood calcium level were associated with the occurrence of CVS in SAH patients(P<0.05),while the gender,alcohol drinking and hyperglycemia were not associated with the occurrence of CVS in SAH patients(P>0.05).Logistic regression analysis showed that the age>55 years old,Fisher gradeⅣ,Hunt-Hess classification>Ⅲ,consciousness disorders,hypertension,white blood cell count>15×10^(9) L^(-1),blood calcium<2.2 mmol·L^(-1) were the independent risk factors for CVS in SAH patients(P<0.05).Conclusion The incidence of CVS is higher after SAH.The older age,higher Fisher and Hunt-Hess classification,consciousness disorders,hypertension,high white blood cell count and low blood calcium level are the independent risk factors for CVS in SAH patients.The corresponding prevention and treatment measures should be formulated according to the risk factors of CVS,so as to reduce the incidence of CVS and improve the prognosis of SAH patients.