| 梁红军.亚低温长时干预治疗高分级动脉瘤继发蛛网膜下腔出血 116例疗效分析[J].安徽医药,2021,25(1):111-114. |
| 亚低温长时干预治疗高分级动脉瘤继发蛛网膜下腔出血 116例疗效分析 |
| Long term mild hypothermia intervention in the treatment of high?gradeaneurysms with subarachnoid hemorrhage:an analysis of 116 cases |
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| DOI：10.3969/j.issn.1009?6469.2021.01.028. |
| 中文关键词: 蛛网膜下腔出血 低温，人工 颅内动脉瘤 预后 危险因素 |
| 英文关键词: Subarachnoid hemorrhage Hypothermia,induced Intracranial aneurysm Prognosis Risk factors 3,61cas,es(52.59%)and19,cases(16.38%).Six,64,cases(55.17%)had, |
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| 中文摘要: |
| 目的探讨亚低温长时干预治疗高分级动脉瘤继发蛛网膜下腔出血(aSAH)疗效及预后危险因素。方法回顾性分析商丘市第三人民医院 2013年 3月至 2019年 3月收治的高分级动脉瘤继发 aSAH病人共 116例，均给予亚低温长时干预，记录临床疗效及随访预后指标，并采用单因素及 logistic回归模型分析病人死亡危险因素。结果全部病人亚低温干预时间为 5～ 14 d，干预时间(7.61±2.94)d；治疗过程中出现心律失常、低血压、下肢深静脉血栓、肺炎、急性呼吸窘迫综合征、应激性溃疡、胃肠功能紊乱、应激性高血糖、低钾血症、脑血管痉挛及脑积水分别为 71例(61.21%)98例(84.48%)19例(16.38%)，62例(53.45%)11例(9.48%)，17例(14.66%)109例(93.97%)35例(30.17%)，49例(42.24，61例(52.59%，19例(16.38%)；而治例(13.79%)；预后良好 645.17%)52例(44.83%)；单因素分析提示，亨特?赫斯(Hunt?Hess)分级 V级和合并脑血管痉挛与病人死亡相关(P＜0.05)；logistic回归模型多因素分析提示， Hunt?Hess分级 V级和合并脑血管痉挛%)，)，疗后死亡16，例(5，预后不良，同时，是病人死亡独立危险因素(P＜0.05)。结论亚低温长时干预治疗高分级动脉瘤继发 aSAH安全有效，而 Hunt?Hess分级 V级和合并脑血管痉挛是该类病人死亡独立危险因素。 |
| 英文摘要: |
| Objective To investigate the clinical effects of mild hypothermia for long?term intervention in the treatment of pa?tients with aSAH secondary to high?grade aneurysms and its prognostic risk factors.Methods Clinical data of 116 patients with aSAH secondary to high?grade aneurysms admitted to Shangqiu Third People’s Hospital from March 2013 to March 2019 were ret?rospectively analyzed.All patients were given long?term mild hypothermia intervention.Clinical efficacy and prognostic indicatorswith follow?up were recorded and the risk factors of death were analyzed using single factor and logistic regression model.Results The intervening time of mild hypothermia were 5?14 days with average intervening time for(7.61±2.94)days.The cases of arrhyth? mia，hypotension，deep venous thrombosis，pneumonia，acute respiratory distress syndrome，stress ulcer，gastrointestinal dysfunction， stress hyperglycemia，hypokalemia，cerebral vasospasm and hydrocephalus occurred in all patients were separately 71 cases(61.21%)98 cases(84.48%)and 19 cases(16.38%)62 cases(53.45%)11 cases(9.48%)17 cases(14.66%)，109 cases(93.97%)5 cases(30.17%)49 cases(42.24%)， teen cases(13.79%)died after treatment； good prognosis and 52 cases(44.83%)had poor prognosis.Univariate analysis showed thatHunt? Hess grade V and cerebral vasospasm were correlated with mortality(P＜0.05).Multivariate analysis of logistic regression modelsuggested that Hunt?Hess grade V and cerebral vasospasm were independent risk factors for mortality(P＜0.05).Conclusion Mild hypothermia for long?term intervention in the treatment of aSAH secondary to high?grade aneurysms is safe and effective；and Hunt?Hess grade V and cerebral vasospasm are independent risk factors for death in those patients. |
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