动脉瘤性蛛网膜下腔出血后症状性脑血管痉挛的相关因素
分析研究
俞学斌;金国良;袁紫刚;鲍武乔
【期刊名称】《浙江创伤外科》 【年(卷),期】2014(000)004
【摘要】Objective To explore the relevant factors of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage. Methods 71 patients with aneurysmal SAH was demonstrated by computed tomography, and in whom one or more intracranial aneurysms had been diagnosed, un-derwent transcranial doppler (TCD) in 72h to calculate the Lindegaard ratios, middle cerebral artery velocity(MCAV), Internal carotid artery blood flow velocity, spasm indexes. The data of age, sex, Hunt and Hess degree, Fisher grade, treatment(coil embolization, surgical clip occlusion, or conservative treatment), smoking history, and hypertension history were collected. Logistic regression was used to evaluate the possible predictive factors. Results In 21 patients (29.6%) symptomatic vasospasm was diagnosed. Logistic analysis indicated that MCAV, Lindegaard ratios and spasm indexes, Hunt-Hess degree, Fisher grade, WBC were the independent risk factors. The selected model for estimation of clinical vasospasm included Fisher grade, MCAV, and spasm index. Conclusion MCAV, Lindegaard ratios and spasm indexes, Hunt-Hess degree, Fisher grade, WBC were the
independent risk factors affecting the symptomatic vasospasm.%目的：探讨动脉瘤性蛛网膜下腔出血后患者症状性脑血管痉挛的相关因素。方法本研究选取71例确诊为动脉瘤性蛛网膜下腔出血的患者为研究对象，在72小时之内行TCD，获得颅内大脑中动脉流速（MCAV）、颈内动脉血流速度、Lindegaard比值、颅内血管痉挛指数（VI）；并同时收集所有患者临床特征：年龄，性别，Hunt-Hess分级，CT Fisher分级，WBC计数（WBC），治疗方法（弹簧圈栓塞，外科夹闭或保守治疗），吸烟史，高血压病史；同时观察患者有无症状性脑血管痉挛发生。用SPSS统计学软件进行统计学分析。结果21例（29．6%）发生症状性脑血管痉挛，单因素分析结果表明：MCAV、Lindegarrd率、VI、WBC计数（WBC）、Hunt-Hess分级、Fisher分级6个因素与是否发生症状性脑血管痉挛明显相关；纳入多因素Logistic回归分析，仅有CT Fisher分级，MCA流速，痉挛指数进入方程。可见对于诊断症状性血管痉挛，最好的多变量模型是选用CT Fisher分级，MCA流速，痉挛指数为变量。结论 MCAV、Lindegarrd率、VI、WBC计数、Hunt-Hess分级、Fisher分级6个因素是发生症状性脑血管痉挛的最重要影响因素。 【总页数】4页(521-524)
【关键词】蛛网膜下腔出血;动脉瘤;脑血管痉挛;经颅多普勒超声 【作者】俞学斌;金国良;袁紫刚;鲍武乔
【作者单位】312000 绍兴，浙江省绍兴市人民医院神经外科;312000 绍兴，浙江省绍兴市人民医院神经外科;312000 绍兴，浙江省绍兴市人民医院神经外科;312000 绍兴，浙江省绍兴市人民医院神经外科 【正文语种】中文
【中图分类】R651.1 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_zhejiang-journal-traumatic-surgery_thesis/0201235044480.html 【相关文献】
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动脉瘤性蛛网膜下腔出血后症状性脑血管痉挛的相关因素分析研究
