[1]文唐敏,陈才华.动脉瘤性蛛网膜下腔出血术后慢性脑积水危险因素分析[J].陆军军医大学学报(原第三军医大学学报),2021,43(22):2474-2479.
　WEN Tangmin,CHEN Caihua.Risk factors of chronic hydrocephalus after operation of aneurysmal subarachnoid hemorrhage[J].J Amry Med Univ (J Third Mil Med Univ),2021,43(22):2474-2479.
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动脉瘤性蛛网膜下腔出血术后慢性脑积水危险因素分析(/HTML )
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陆军军医大学学报（原第三军医大学学报）[ISSN:1000-5404/CN:51-1095/R]

卷:
43卷
期数:
2021年第22期
页码:
2474-2479
栏目:
临床医学
出版日期:
2021-11-30

文章信息/Info

Title:
Risk factors of chronic hydrocephalus after operation of aneurysmal subarachnoid hemorrhage
作者:
文唐敏; 陈才华
重庆市长寿区人民医院神经外科
Author(s):
WEN Tangmin;  CHEN Caihua
Department of Neurosurgery, Changshou Distict People’s Hospital, Chongqing, 401220, China
 
关键词:
动脉瘤; 蛛网膜下腔出血; 脑积水; 危险因素
Keywords:
 ; 
分类号:
R181.32; R742.7; R743.35
文献标志码:
A
摘要:
目的分析动脉瘤性蛛网膜下腔出血术后发生慢性脑积水的独立危险因素。方法回顾性分析2014年12月至2020年12月我院神经外科收治的99例动脉瘤性蛛网膜下腔出血患者，查阅病历资料记录患者年龄、性别、烟酒史、高血压病史、出血是否破入脑室、是否合并脑内血肿、动脉瘤位置、发生出血的次数、入院Fisher分级、Hunt-Hess分级、是否行腰大池引流术、是否行脑室外引流、是否颅内感染。99例手术治疗的动脉瘤性蛛网膜下腔出血患者中，发生慢性脑积水30例，未发生脑积水69例，采用单因素和多因素Logistic回归分析筛选发生脑积水的危险因素。结果单因素方差分析结果显示：年龄、Fisher分级、Hunt-Hess分级高和多次出血明显增加术后慢性脑积水的发生率（P<0.05）。χ2检验结果显示：出血破入脑室、脑内血肿、腰大池引流、脑室外引流以及颅内感染等明显增加慢性脑积水的发生率（P<0.05）。二元Logistic回归分析结果显示：动脉瘤性蛛网膜下腔出血术后发生慢性脑积水的独立危险因素有蛛网膜下腔出血破入脑室（P=0.003）、合并脑内血肿（P=0.005）、Hunt-Hess分级较高（P=0.006）、Fisher分级较高（P=0.011）、行脑室外引流（P=0.005）、行腰大池引流（P=0.008）、颅内感染（P=0.039）。结论出血破入脑室、合并脑内血肿、高等级的Hunt-Hess与Fisher分级、脑室外引流、腰大池引流、颅内感染等均是动脉瘤蛛网膜下腔出血患者术后发生慢性脑积水的独立危险因素。
 
Abstract:

ObjectiveTo identify the independent risk factors of chronic hydrocephalus in patients after the operation of aneurysmal subarachnoid hemorrhage (aSAH). MethodsThe clinical data of 99 patients with aSAH treated in our hospital from December 2014 to December 2020 were collected and retrospectively analyzed, including age, gender, history of smoking and drinking, hypertension, intraventricular hemorrhage or not, complicated with intracerebral hematoma or not, lumbar cistern drainage, ventricular drainage, intracranial infection or not, location of aneurysm, frequency of hemorrhage, and results of Fisher Grading Scale and Hunt-Hess Classification of SAH. Among the 99 cases of aSAH, 30 patients developed postoperative chronic hydrocephalus. Univariate and multivariate logistic regression analysis were performed to screen the risk factors of chronic hydrocephalus. ResultsThe results of one-way ANOVA indicated that older age, higher Fisher grade and Hunt-Hess grade, and more bleeding times significantly increased the incidence of postoperative chronic hydrocephalus (P<0.05); meanwhile, Chi-square test showed that intraventricular hemorrhage, intracerebral hematoma, lumbar cistern drainage, ventricular drainage, intracranial infection also resulted in elevated incidence of postoperative chronic hydrocephalus (P<0.05). Multiple logistic regression analysis presented that intraventricular hemorrhage (P=0.003), intracerebral hematoma (P=0.005), higher Hunt-Hess grade (P=0.006), higher Fisher grade (P=0.011), ventricular drainage (P=0.005), lumbar cistern drainage (P=0.008) and intracranial infection (P=0.039) were independent risk factors of chronic hydrocephalus after aSAH operation. ConclusionIntraventricular hemorrhage, intracerebral hematoma, higher Hunt-Hess grade and Fisher grade, lumbar cistern drainage, ventricular drainage, and intracranial infection are independent risk factors of postoperative chronic hydrocephalus in patients with aSAH.

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更新日期/Last Update: 2021-11-23