显微手术治疗重症动脉瘤性蛛网膜下腔出血临床预后影响因素分析
DOI:
作者:
作者单位:

作者简介:

陈建屏,男,主任医师,医学学士.Email:cjpfjxh@163.com

通讯作者:

中图分类号:

基金项目:


Analysis of Risk Factors for Clinical Prognosis of Patients with SevereAneurysmal Subarachnoid Hemorrhage Treated by Micro-Surgery
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的 分析显微手术治疗重症动脉瘤性蛛网膜下腔出血(SaSAH)患者预后的影响因素。 方法 回顾性分析2010年1月—2020年1月67例SaSAH患者的临床资料,经数字减影血管造影(DSA)或CT血管成像(CTA)证实为单发颅内责任动脉瘤且经头部CT证实有蛛网膜下腔出血,对SaSAH患者行动脉瘤手术夹闭术,术后予营养支持、营养神经等治疗。根据患者出院后1 a的格拉斯哥评分(GOS)评估预后,并分为预后良好组(39例)和预后不良组(28例)。记录两组患者的临床资料(性别、年龄、责任动脉瘤部位、Hunt-Hess分级、高血压病史、糖尿病史、吸烟史),并进行组间比较。对SaSAH患者临床预后影响因素进行单因素和多因素分析。 结果 单因素分析显示,年龄、Hunt-Hess分级是影响SaSAH患者临床预后的因素( P <0.05);性别、高血压病、糖尿病、吸烟、责任动脉瘤部位不是影响SaSAH患者临床预后的因素( P >0.05)。多因素分析显示,年龄高低和Hunt-Hess分级是影响SaSAH患者临床预后的因素( P <0.05)。年龄≥60岁的SaSAH患者临床预后差的风险是年龄<60岁的SaSAH患者的5.430倍。Hunt-Hess分级每增加1个单位,SaSAH患者临床预后差的风险增加3.231倍。 结论 与低龄和低级别SaSAH患者比较,高龄和高级别Hunt-Hess分级的SaSAH患者预后较差。临床中遇到高Hunt-Hess分级或高龄的SaSAH患者时,术前需进行详细评估,制订个体化、针对性强的治疗方案,尽可能降低不良临床预后的发生率。

    Abstract:

    ObjectiveTo analyze the risk factors of clinical prognosison in patients with severe aneurysmal subarachnoid hemorhage (SaSAH) treated by surgical clipping. Methods From January 2010 to January 2020, 67 cases of SaSAH patients diagnosed by digital subtraction angiography (DSA) or CT angiography (CTA) and subarachnoid hemorrhage diagnosed by head CT. Intracranial aneurysm was treated by surgical clipping followed by nutritional support, neurocritical care and management. Follow up was performed 1 year after discharge by recording glasgow outcome scale (GOS), and the patients were divided into good prognosis group (39 cases) and poor prognosis group (28 cases). The clinical data of two groups were recorded, including gender, age, location of responsible aneurysm, Hunt-Hess grade, history of hypertension, history of diabetes and history of smoking. Univariate analysis and multivariate analysis were performed on the influencing factors of clinical prognosis of SaSAH patients. Results Univariate analysis showed that age and Hunt-Hess Scale were the risk factors of clinical prognosis in patients with SaSAH (P<0.05). Gender, hypertension, diabetes, smoking history and location of responsible aneurysms were not the factors influencing the prognosis of SaSAH patients (P>0.05). Multivariate analysis showed that age and Hunt-Hess Scale were the risk factors of clinical prognosis in patients with SaSAH (P<0.05). The risk of poor clinical prognosis in SaSAH patients aged ≥60 years was 5.430 times higher than that in SaSAH patients aged <60 years. The risk of poor clinical prognosis in patients with SaSAH increased by 3.231 times for each additional unit of Hunt-Hess Scale. Conclusion Compared with low age and low Hunt-Hess grade SaSAH patients, venerable age and high Hunt-Hess grade indicate poor prognosis. When SaSAH patients with high Hunt-Hess grade or venerable age are encountered in clinic, a comprehensive evaluation needs to be carried out before operation, and an individualized and targeted treatment plan should be formulated to reduce the incidence of adverse clinical prognosis as much as possible.

    参考文献
    相似文献
    引证文献
引用本文

陈建屏,林祺,张志鹏.显微手术治疗重症动脉瘤性蛛网膜下腔出血临床预后影响因素分析[J].福建医科大学学报自然版,2021,55(6):18-21

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2022-02-17
  • 出版日期: