摘要
目的:探讨影响腰大池引流降低动脉瘤性蛛网膜下腔出血(aSAH)后分流依赖性脑积水发生率的相关因素。方法:回顾性分析2011年1月至2013年1月在浙江大学医学院附属第二医院治疗的且在围手术期行腰大池引流的136例颅内动脉瘤患者资料,分析分流依赖性脑积水发生的相关因素。结果:23例患者(16.91%)发生分流依赖性脑积水。单因素分析显示以下因素可能与分流依赖性脑积水发生相关:入院时Hunt-Hess分级(P<0.01)和Fisher分级(P<0.01);脑室内出血(P<0.01);破裂动脉瘤部位(P=0.001);平均每日脑脊液引流量(P=0.047)。结论:aSAH患者入院时Hunt-Hess分级差、Fisher分级高、出现脑室内出血、后循环破裂动脉瘤,或者平均每日脑脊液引流量过多或过少,其分流依赖性脑积水发生率较高。
Objective： To investigate risk factors for the occurrence of shunt- dependent hydrocephalus in patients with aneurysmal subarachnoid hemorrhage （aSAH）. Methods： A cohort of 136 consecutive patients who were treated for ruptured aneurysms within 72 h after onset of aSAH from January 2011 to January 2013 wereretrospectively analyzed. Lumbar drainage was performed during the surgery in all patients. The risk factors of shunt-dependent hydrocephalus were analyzed. Results： Of 136 patients, 23 （16. 91% ） underwent shunt operation to treat shunt-dependent hydrocephalus. Univariate analysis showed that Hunt-Hess grade at admission （P 〈 0. 01 ）, Fisher grade （ P 〈 0. 01 ）, the presence of intraventricular hemorrhage （ P 〈 0. 01 ） ,location of ruptured aneurysm （ P = 0. 001 ）, and the average daily volume of cerebrospinal fluid drainage （CSF） （P = 0.047） were associated with shunt-dependent hydrocephalus. Conclusion： The aSAH patients with poor Hunt-Hess grade at admission, high Fisher grade, the presence of intraventricular hemorrhage, ruptured aneurysm in posterior circulation, and abnormal average daily volume of CSF are more likely to develop shunt-depended hydrocephalus.
出处
《浙江大学学报（医学版）》
CAS
CSCD
北大核心
2014年第1期71-76,共6页
Journal of Zhejiang University(Medical Sciences)
基金
国家自然科学基金(81171094)
卫生部科学研究基金(WKJ2009-2-025)
关键词
动脉瘤
颅内动脉瘤
并发症
脑积水
脑脊髓液分流术
腰骶部
蛛网膜下腔出血
统计学(主题)
回顾性研究
Aneurysm
Intracranial aneurysm/complications
Hydrocephalus
cerebrospinal fluid shunts
Lumbosacral region
Subarachnoid hemorrhage
Statistics（as topic）
Retrospective studies
