| 张彬,陈节,崔明.老年人动脉瘤性蛛网膜下腔出血115例回顾性分析[J].安徽医药,2019,23(4):784-787. |
| 老年人动脉瘤性蛛网膜下腔出血115例回顾性分析 |
| Aneurysmal subarachnoid hemorrhage in the elderly population: a retrospective analysis of 115 cases |
| 投稿时间：2017-10-25 |
| DOI： |
| 中文关键词: 颅内动脉瘤 蛛网膜下腔出血 动脉瘤,破裂 栓塞,治疗性 血管造影术,数字减影 老年人 |
| 英文关键词: Intracranial aneurysm Subarachnoid hemorrhage Aneurysm,ruptured Embolization,therapeutic Angiography,digital subtraction Aged |
| 基金项目: |
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| 中文摘要: |
| 目的 研究老年人动脉瘤性蛛网膜下腔出血的发病特点。方法 将2013年1月至2017年3月铜陵市人民医院收治的动脉瘤性蛛网膜下腔出血115例病人按年龄分为两组,即老年组(年龄≥60岁)与非老年组(年龄＜60岁),收集相关资料,回顾性分析两组病人动脉瘤的一般发病特点。结果 115例病人中,载瘤动脉集中分布于大脑中动脉、前交通动脉、后交通动脉,分别为19例(16.5%)、38例(33.0%)、41例(35.7%)。老年组后交通动脉瘤占比(51%)高于非老年组(23.4%),大脑中动脉瘤占比(7.8%)低于非老年组(23.4%),均差异有统计学意义(P＜0.05)；老年组前交通动脉瘤占比(27.5%)与非老年组(37.5%)差异无统计学意义(P＞0.05)。老年组中以女性发病为主(72.5%,P＜0.05)。两组病人动脉瘤直径、入院时改良Fisher分级、Hunt-Hess(H-H)分级、病死率、出院时格拉斯哥预后评分(Glasgow Outcome Scale,GOS)均差异无统计学意义(P＞0.05),GOS为因变量的二元logistic回归分析中,只有H-H分级为评估病人预后的预测因子,呈负相关关系(P＜0.05)。 结论 H-H分级应该可以成为评估动脉瘤病人预后的可靠指标。老年人动脉瘤病人以女性多见,载瘤动脉主要多见于后交通动脉。老年人起病及预后较非老年病人无明显区别,当其H-H分级Ⅳ级及以下时,均应积极进行治疗,年龄不应为临床医师首要考虑的因素。 |
| 英文摘要: |
| Objective To investigate the onset characteristics of aneurysmal subarachnoid hemorrhage (aSAH) in the elderly patients. Methods One hundred and fifteen patients undergoing the treatment of aSAH in Tongling People's Hospital from January 2013 to March 2017 were selected as study subjects and assigned into elderly group (age≥60 years) and non-elderly group (age＜60 years). The onset characteristics of aneurysmal subarachnoid hemorrhage were analyzed. Results Aneurysms primarily located in middle cerebral artery (MCA,19 cases,16.5%),anterior communicating artery (AComA,38 cases,33.0%) and posterior communicating artery (PComA,41 cases,35.7%). The composition ratio of PComA in elderly group (51%) was higher than that in non-elderly group (23.4%), and the ratio of MCA (7.8%) in elderly group was lower than that in non-elderly group (23.4%);the difference was statistically significant (P＜0.05). There was no significant difference in the ratio of AComA between elderly group (27.5%) and non-elderly group (37.5%) (P>0.05). There were no significant differences between the two groups in the aneurysm diameter,modified Fisher grading at admission,Hunt-Hess (H-H) scale,Glasgow Outcome Scale (GOS) at discharege and mortality (P＞0.05). Logistic multivariable analysis with GOS as dependent variable showed that H-H scale was the predictive factor for prognosis,which was negatively correlated to prognosis (P＜0.05). Conclusions H-H scale could be the reliable indicator for the evaluation of prognosis. The patients in elderly group were mainly females,and aneurysms primarily located in PComA in elderly population. There was no significant difference in prognosis between the elderly and non-elderly group. Thus elderly patients,whose H-H grade was less than or equal to Ⅳ level,should be treated positively. Age was not the independent risk factor. |
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