外伤性与动脉瘤性蛛网膜下腔出血脑血管痉挛的对比分析

发布时间：2018-12-14 21:26

【摘要】：目的对比分析外伤性与动脉瘤性蛛网膜下腔出血发生脑血管痉挛的危险因素。方法收集50例外伤性蛛网膜下腔出血(TSAH)和72例动脉瘤性蛛网膜下腔出血(ASAH)的临床资料,采用单因素分析法及多因素Logistic回归分析法分析两组患者发生脑血管痉挛(CVS)的危险因素。结果TSAH患者体温,白细胞计数和舒张压水平均高于ASAH患者(P=0.041;P=0.005;P=0.000)。单因素分析发现高血压和Fisher分级对TSAH组发生CVS有显著影响(P=0.031;P=0.012);吸烟,二次出血,Fisher分级及Hunt-Hess分级对ASAH组发生CVS有显著影响(P=0.044;P=0.002;P=0.025;P=0.010);多因素Logistic回归分析发现对于TSAH患者,仅Fisher分级是CVS的危险因素(OR=0.237,95%CI 0.065-0.857,P=0.028);对于ASAH患者,二次出血(OR=12.035,95%CI 1.645-88.028,P=0.014),Fisher分级(OR=0.200,95%CI 0.056-0.717,P=0.013)和Hunt-Hess分级(OR=0.259,95%CI 0.073-0.919,P=0.037)是发生CVS的危险因素。结论对于TSAH患者,仅Fisher分级是发生CVS的危险因素;而对于ASAH患者,其发生CVS的危险因素包括二次出血,Fisher分级和Hunt-Hess分级。
[Abstract]:Objective to compare and analyze the risk factors of cerebral vasospasm between traumatic subarachnoid hemorrhage and aneurysm subarachnoid hemorrhage. Methods the clinical data of 50 cases of traumatic subarachnoid hemorrhage (TSAH) and 72 cases of aneurysm subarachnoid hemorrhage (ASAH) were collected. Single factor analysis and multivariate Logistic regression analysis were used to analyze the risk factors of cerebral vasospasm (CVS) in the two groups. Results the temperature, white blood cell count and diastolic blood pressure in TSAH patients were higher than those in ASAH patients (P0.041, P0. 005, P0. 000). Univariate analysis showed that hypertension and Fisher grade had significant influence on the occurrence of CVS in TSAH group (P0.031, P0.012), smoking, secondary hemorrhage, Fisher grade and Hunt-Hess grade had significant effects on CVS occurrence in ASAH group (P0.044, P0. 002, P0. 025). Multivariate Logistic regression analysis showed that only Fisher grade was the risk factor of CVS in patients with TSAH (OR=0.237,95%CI 0.065-0.857P0.028). For ASAH patients, secondary hemorrhage (OR=12.035,95%CI 1.645-88.028) P0.014), Fisher grade (OR=0.200,95%CI 0.056-0.717) and Hunt-Hess grade (OR=0.259,95%CI 0.073-0.919), P0. 037) is a risk factor for CVS. Conclusion for TSAH patients, only Fisher grade is the risk factor for CVS, while for ASAH patients, the risk factors for CVS include secondary hemorrhage, Fisher grade and Hunt-Hess grade.
【作者单位】：西安市长安区医院神经内科;
【分类号】：R743.35

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