动脉瘤性蛛网膜下腔出血后脑血管痉挛危险因素的分析

Analysis of risk factors for cerebral vasospasm after aneurysmal subarachnoid hemorrhage

摘要:

目的 探讨动脉瘤性蛛网膜下腔出血后脑血管痉挛的危险因素。方法 回顾性分析93例动脉瘤性蛛网膜下腔出血患者的临床资料，研究脑血管痉挛的危险因素。结果 93例动脉瘤性蛛网膜下腔出血患者中共有28 例患者（30.1%）发生脑血管痉挛。Hunt-Hess分级≥Ⅲ级血管痉挛发生率明显高于Hunt-Hess分级Ⅰ-Ⅱ级，差异有统计学意义（P<0.01）；Fisher分级≥Ⅲ级血管痉挛发生率明显高于Fisher分级Ⅰ-Ⅱ级，差异有统计学意义（P<0.01）；白细胞计数>15×10⁹的患者脑血管痉挛发生率（41.9%，18/43）明显升高（P<0.05）。结论 Hunt-Hess分级≥Ⅲ级、Fisher分级≥Ⅲ级、白细胞计数增高是蛛网膜下腔出血后脑血管痉挛的危险因素。

Abstract:

Objective To investigate the risk factors for cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH).Methods A retrospective analysis was performed on the clinical data of 93 patients with aSAH to investigate the risk factors for CVS.Results Of the 93 patients, 28 (30.1%) had CVS. The patients with Hunt-Hess grade≥Ⅲ aSAH had a significantly higher incidence of CVS than those with Hunt-Hess grade I-Ⅱ aSAH (50.0% vs 16.9%, P<0.01). The patients with Fisher grade≥Ⅲ aSAH had a significantly higher incidence of CVS than those with Fisher grade I-Ⅱ aSAH (54.1% vs 14.3%, P<0.01). The patients with a white blood cell count greater than 15×10⁹/L had a significantly higher incidence of CVS than those with a cell count less than or equal to 15×10⁹/L (41.9% vs 20%, P<0.05).Conclusions Hunt-Hess grade≥Ⅲ, Fisher grade≥Ⅲ, and increased white blood cell count are the risk factors for CVS after aSAH.