摘要
目的探讨颅内动脉瘤再出血发生的诱因、时间，动脉瘤的位置、大小及Hunt-Hess分级与再出血发生的关系和再出血对患者预后的影响。方法回顾性分析21例颅内动脉瘤再出血患者再出血的诱因，再出血的次数、间隔时间；与未发生再出血的59例进行比较，分析动脉瘤的位置、大小、Hunt-Hess分级与再出血发生的关系，比较两组患者的预后。结果再出血的诱因有高血压、情绪异常、用力排便、过早搬动、下床活动；再出血发生的高峰时期在首次出血后的第1、2周和第4周；前后循环动脉瘤再出血的发生率近似（P〉0．05）；动脉瘤直径〈5mm、5-10min、〉10min的患者的再出血的发生率两两比较，差异无统计学意义（P均〉0．05）；Hunt-Hess分级Ⅳ-Ⅴ级患者的再出血的发生率明显高于Ⅰ-Ⅲ级者（P〈0．01）；再出血组者的预后较未再出血者的预后差（P〈0．05）。结论再出血的发生严重影响患者的预后，注意在第1、2、4周发生再出血的可能，对颅内动脉瘤患者首次出血要及早诊治。
Objective To explore the inducement, time of rebleeding,the relationship between the location, the size , Hunt-Hess grade and the rebleeding respectively and its influence on the patients/prognosis. Methods Twenty-one patients with cerebral aneurysms rebleeded, we analyzed the induicements of rebleeding, times and time interval;Another 59 patients during the same period were made as control group, we analyzed the relationship between location, size of aneurysm, grade of Hunt-Hess and rebleeding respectively, prognosis between two groups. Results The inducements of rebleeding were hypertension.emotion abnormity.harder defecate.moved earlier; ＂high risk＂ period of rebleeding was the 1st,2nd and 4th week after aneurysm rupture; the rebleeding of aneurysm between in the anterior circulation and in the posterior circulation were found no significinant difference（P 〉0.05） ;There was no significinant difference in the either two groups of the reblecding of the patients with the size of aneurysm 〈5 mm,5 - 10 mm, 〉 10 mm;Patients with Hunt-Hess grade Ⅳ - Ⅴ were easyier to rebleed than that with Hunt-Hess grade Ⅰ - Ⅲ （P 〈 0.01 ）, the prognosis of the rebleeding group were much worse than that of non-rebleeding group （P 〈 0.05）. Conclusions The rebleeding affects the patients＇ prognosis greatly, We should be aware of the possibility of rebleeding at the 1 st,2nd and 4th week after aneurysm rupture , the early diagnosis and treatment are urgent for the patients with cerebral anurysm after the first subarachnoid hemorrhage.
出处
《山东医药》
CAS
北大核心
2008年第12期20-21,共2页
Shandong Medical Journal
基金
山东省自然科学基金资助项目[Y2006C45]
关键词
颅内动脉瘤
颅内再出血
cerebral aneurysm
intracranial hemorrhage
