[1]潘逸珩　雷军荣　段　波　魏德胜　陈　亮　陈志明　秦　军.动脉瘤性蛛网膜下腔出血术后脑梗死的临床特点及其发生的危险因素分析[J].中国临床神经外科杂志,2017,(01):4-6,10.[doi:10.13798/j.issn.1009-153X.2017.01.002]
　PAN Yi-heng,LEI Jun-rong,DUAN Bo,et al.Analysis of clinical features of postoperative cerebral infarction and the factors related to it in patients with aneurysmal subarachnoid hemorrhage[J].,2017,(01):4-6,10.[doi:10.13798/j.issn.1009-153X.2017.01.002]
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动脉瘤性蛛网膜下腔出血术后脑梗死的临床特点及其发生的危险因素分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年01期
页码:
4-6,10
栏目:
论著
出版日期:
2017-01-18

文章信息/Info

Title:
Analysis of clinical features of postoperative cerebral infarction and the factors related to it in patients with aneurysmal subarachnoid hemorrhage
文章编号:
1009-153X（2017）01-0004-03
作者:
潘逸珩　雷军荣　段　波　魏德胜　陈　亮　陈志明　秦　军
442000 湖北，十堰市太和医院神经外科
Author(s):
PAN Yi-heng;  LEI Jun-rong;  DUAN Bo;  WEI De-sheng;  CHEN Liang;  CHEN Zhi-ming;  QIN Jun.
Department of Neurosurgery II, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
关键词:
动脉瘤性蛛网膜下腔出血; 夹闭术; 血管内栓塞; 脑梗死; 危险因素
Keywords:
Aneurysmal subarachnoid hemorrhage;  Postoperative cerebral infarction;  Risk factor;  Clinical features
分类号:
R 743.9; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2017.01.002
文献标志码:
A
摘要:
目的 探讨动脉瘤性蛛网膜下腔出血（aSAH）术后脑梗死的临床特点及其发生的危险因素。方法 2010年1月至2015年6月收治aSAH 225例，采用开颅夹闭术治疗106例，栓塞治疗119例；采用Logistic回归分析检验术后脑梗死发生的危险因素。结果 共47例术后出现脑梗死，发生率为20.9%；术后1 d出现19例，4~16 d出现28例；单侧脑梗死29例；单发脑梗死25例；皮层脑梗死28例，皮层下脑梗死9例，混合型脑梗死10例。多因素Logistic回归分析显示，入院Hunt-Hess分级高、改良Fisher分级高、合并症状性脑血管痉挛及未使用尼莫地平是aSAH术后发生脑梗死的独立危险因素（P<0.05）。结论 aSAH术后脑梗死的发生率较高，尤其是入院Hunt-Hess分级高、改良Fisher分级高、合并症状性脑血管痉挛的患者。
Abstract:
Objective To explore the clinical features and risk factors of postoperative cerebral infarction (PCI) in the patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods The clinical data of 225 patients with aSAH treated in our hospital from January, 2010 to June, 2015 were reviewed. The clinical features and its risk factors of PCI were analyzed. Results Of 225 patients with aSAH, 47 (20.89%) had PCI and 178 not. Of 47 aSAH patients with PCI, 19 suffered from the PCI 1 day after surgery and 28 from 4 to 16 days after operation. There was unilateral cerebral infarction in 29 patients and there was single cerebral infarction focus in each of 25. There was cortical infarction in 28 patients, there was subcortical infarction in 9 and there was mixed type of cerebral infarction in 10. Univariate analysis showed that risk factors related to the PCI included hypertension, high Hunt-Hess grade and high improved Fisher grade, rebleeding, and symptomatic cerebral vasospasm (P<0.05) and nimodipine had prevention of the PCI (P<0.05). Multivariate logistic regression analysis revealed that high Hunt-Hess grade and high improved Fisher grade and symptomatic cerebral vasospasm were independent risk factors for the PCI (P<0.05) and nimodipine had significant preventive effect on the PCI. Conclusions There is high incidence of the PCI in the patients with aSAH, especially in the aSAH patients with high Hunt-Hess grade, high improved Fisher grade or symptomatic cerebral vasospasm, in whom mimodipine should be used to prevent the PCI.

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备注/Memo

备注/Memo:
通讯作者：秦　军，E-mail：pikowen@126.com
更新日期/Last Update: 2016-10-28