自发性蛛网膜下腔出血后并发脑血管痉挛的影响因素研究

Study on the Influencing Factors of Cerebral Vasospasm after Spontaneous Subarachnoid Hemorrhage

目的:探讨自发性蛛网膜下腔出血(SAH)后并发脑血管痉挛(CVS)的影响因素。方法:选取2021年1月-2022年4月粤北人民医院收治的120例自发性SAH患者为研究对象,根据是否并发CVS将其分为CVS组(n=38)和无CVS组(n=82)。比较两组患者基本临床信息和实验室指标,并将有统计学差异的因素纳入logistic回归模型,分析自发性SAH患者并发CVS的影响因素。结果:两组年龄、高血压、动脉瘤位置、动脉瘤破裂史、Fisher分级、Hunt-Hess分级比较,差异均有统计学意义(P<0.05)。CVS组血糖、白细胞计数、中性粒细胞百分比均高于无CVS组,血钙、血钠、血镁均低于无CVS组,差异均有统计学意义(P<0.05)。logistic回归分析结果显示,年龄、血钙、血钠、Fisher分级、白细胞计数、Hunt-Hess分级、动脉瘤破裂史均为自发性SAH患者合并发CVS的影响因素(P<0.05)。结论:自发性SAH患者并发CVS的因素较多,包括高龄、低血钠、低血钾、白细胞计数升高、动脉瘤破裂史、Fisher分级以及Hunt-Hess分级,临床应当针对影响因素及时给予针对性干预,降低CVS风险。

Objective:To explore the influencing factors of cerebral vasospasm(CVS)after spontaneous subarachnoid hemorrhage(SAH).Method:A total of 120 patients with spontaneous SAH admitted to Yue Bei People’s Hospital from January 2021 to April 2022 were selected as the study subjects,and they were divided into CVS group(n=38)and non-CVS group(n=82)according to whether they were complicated with CVS.The basic clinical information and laboratory indicators of patients in the two groups were compared,and the different factors were incorporated into the logistic regression model to analyze the influencing factors of spontaneous SAH patients with CVS.Result:There were statistically significant differences in age,hypertension,aneurysm location,aneurysm rupture history,Fisher grade and Hunt-Hess grade between the two groups(P<0.05).Blood glucose,white blood cell count and neutrophil percentage in CVS group were higher than those in non-CVS group,blood calcium,blood sodium and blood magnesium were lower than those in non-CVS group,the differences were statistically significant(P<0.05).logistic regression analysis showed that age,blood calcium,blood sodium,Fisher’s grade,white blood cell count,Hunt-Hess grade and aneurysm rupture history were all influential factors for CVS in spontaneous SAH patients(P<0.05).Conclusion:There are many factors associated with CVS in spontaneous SAH patients,including advanced age,low blood sodium,low blood potassium,elevated white blood cell count,history of aneurysm rupture,Fisher’s grade and Hunt-Hess grade,and timely targeted intervention should be given according to the influencing factors to reduce the risk of CVS.