合并症对脑动脉瘤破裂引起蛛网膜下腔出血老年患者早期预后的影响

发布时间：2018-09-14 08:01

【摘要】：目的探讨合并症对脑动脉瘤破裂引起蛛网膜下腔出血(SAH)患者早期预后的影响。方法纳入2000年至2016年于本院收治的经CT证实的223例SAH患者,其中无合并症组80例,患有高血压、高血糖等老年常见疾病的患者143例,入院治疗前统计患者的合并症情况及格拉斯哥昏迷评分法(Glasgow Coma Score,GCS)和世界神经外科医师联盟(The World Federation of Neurosurgical Societies,WFNS)评分,对SAH患者进行初始治疗干预后,采用格拉斯哥预后评分法(GOS)评价两组SAH患者的早期预后,分析各个合并症对合并症组患者预后的影响。T检验比较年龄等计量资料的差异,卡方检验比较性别等计量资料的差异,秩和检验比较GCS等等级资料的组建差异,logistic回归分析影响患者预后的合并症。结果合并症组与非合并症组比较,患者年龄、性别、GCS分级差别不具有统计学差异(P0.05),而合并症组的WFNS分级整体高于非合并症组(P0.05)。入院治疗30天后,非合并症组约有71.1%的患者恢复情况较好,合并症组仅有49.7%的患者预后较好。高血压、高血糖和高血脂患者的预后较非该疾病的患者预后差,差异具有统计学意义(P0.05),而冠心病患者和癌症患者的预后评分与非该疾病患者的预后评分无统计学差异(P0.05)。logistic多因素回归分析结果显示高血压和糖尿病SAH的危险因素(OR=1.801和1.533),而高血脂不是SAH的危险因素。结论本研究中高血压和高血糖是脑动脉瘤破裂导致的蛛网膜下腔出血老年患者预后的危险因素。
[Abstract]:Objective to investigate the effect of complications on early prognosis of patients with subarachnoid hemorrhage (SAH) caused by rupture of cerebral aneurysm. Methods A total of 223 patients with SAH confirmed by CT were enrolled in our hospital from 2000 to 2016, including 80 patients without complications, 143 patients with common diseases such as hypertension, hyperglycemia, etc. Before admission, the complications and Glasgow coma score (Glasgow Coma Score,GCS) and the World Union of Neurosurgeons (The World Federation of Neurosurgical Societies,WFNS) scores were counted. After the initial intervention of SAH patients, Glasgow prognostic score (GOS) was used to evaluate the early prognosis of the two groups of SAH patients. The influence of each complication on the prognosis of the patients was analyzed. Rank sum test (RSR) was used to compare the difference of GCS grade data and the complications of logistic regression analysis. Results there was no significant difference in the age and sex of the patients compared with the non-complication group (P0.05), but the WFNS grade of the complicated group was higher than that of the non-complicated group (P0.05). After 30 days of admission, 71.1% of the patients in the non-complication group recovered well, and only 49.7% of the patients in the complicated group had a better prognosis. The prognosis of patients with hypertension, hyperglycemia and hyperlipidemia was worse than that of patients without the disease. The difference was statistically significant (P0.05), but the prognostic scores of patients with coronary heart disease and cancer were not significantly different from those of patients without the disease (P0.05). Logistic multivariate regression analysis showed that the risk factors of SAH in hypertension and diabetes mellitus (OR=1.801) were not significantly different from those in patients with coronary heart disease and cancer (P0.05). And 1.533), and hyperlipidemia is not a risk factor for SAH. Conclusion Hypertension and hyperglycemia are risk factors for prognosis of elderly patients with subarachnoid hemorrhage caused by rupture of cerebral aneurysm.
【作者单位】：河北医科大学沧州临床医学院沧州市中心医院老年内科;河北医科大学沧州临床医学院沧州市中心医院神经内三科;
【基金】：沧州市科技计划项目(131302062)
【分类号】：R743.35

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