目的:探讨自发性蛛网膜下腔出血后并发急性脑积水的相关危险因素。方法:选取西安市中心医院神经外科收治的162例蛛网膜下腔出血的患者作为研究对象,统计患者的年龄、性别、饮酒史、吸烟史、高血压病史、糖尿病史、入院时是否昏迷、入院时是否呕吐、GCS评分、脑室出血、早期腰大池引流术、早期锥颅置管引流术、颅内动脉瘤等相关资料,本研究采用二元Logistic回归模型,深入剖析自发性蛛网膜下腔出血(SAH)患者并发急性脑积水(AHC)的相关危险因素。P 0.05。是否有动脉瘤与急性脑积水的发生无统计学意义,P = 0.663。Hunt-Hess分级更高的患者发生急性脑积水的比例Hunt-Hess分级低的患者;患急性脑积水的患者动脉瘤直径大于未患急性脑积水的患者;动脉瘤位置、是否接受动脉瘤栓塞术无统计学意义,P > 0.05。多因素Logistic回归分析显示,年龄、GCS Objective: To explore the associated risk factors for the development of acute hydrocephalus following spontaneous subarachnoid hemorrhage. Methods: A total of 162 patients with spontaneous subarachnoid hemorrhage admitted to the Department of Neurosurgery at Xi’an Central Hospital were selected as the subjects of this study. Data including patient age, gender, drinking history, smoking history, history of hypertension, history of diabetes, coma on admission, vomiting on admission, GCS score, intracerebral hemorrhage, early ventricular hemorrhage, early lumbar puncture, early placement of external ventricular drainage, intracranial aneurysm, and other relevant information were collected. Multifactor Logistic regression analysis was used to assess the associated risk factors for the development of acute hydrocephalus in patients with spontaneous subarachnoid hemorrhage. A P-value of less than 0.05 was considered to indicate statistical significance. Results: Patients who developed acute hydrocephalus had a higher average age than those who did not;the p
本研究旨在对比持续腰大池引流术与脑脊液置换术在治疗自发性蛛网膜下腔出血患者中的疗效。方法 通过随机选取的60例患者,将其分为两组,分别接受上述两种治疗方法。评估指标包括治疗达标率、并发症发生率、手术满意度及患者生存质量。结果 采用持续腰大池引流术的干预组在治疗达标率(96.67% VS 76.67%)、手术满意度(96.67% VS 73.33%)上均显著优于对照组,且并发症发生率(6.67% VS 36.67%)明显低于对照组。这些发现表明,在自发性蛛网膜下腔出血的治疗中,持续腰大池引流术具有更高的治疗效率和更低的并发症风险,值得临床推广。两组患者干预前后生存质量评价SSRS、ESCA评分无显著差异(P均>0.05),但干预组干预后ESCA评分显著高于对照组(132.14±3.95 VS 105.39±3.56,P=0.005)。WHOQOL-100量表评分对比显示,干预组的躯体功能、角色功能、情绪功能、社会功能、认知功能领域及总体生存质量的评分均明显高于对照组(P均<0.05)。结论 持续腰大池引流术相比脑脊液置换术在治疗自发性蛛网膜下腔出血患者方面,不仅能提高治疗的达标率,降低并发症的发生,且手术满意度高,能显著提高患者的生存质量。
