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影响动脉瘤性蛛网膜下腔出血术后脑积水发生的因素:一项临床研究

Factors that Affect Postoperative Hydrocephalus Development in Aneurysmal Subarachnoid Hemorrhage: A Clinical Study.

作者信息

Kilic Mustafa, Yilmaz Ilhan, Tanriverdi Osman, Akgun Cem, Musluman Ahmet Murat, Yilmaz Adem

机构信息

Sisli Hamidiye Etfal Research and Education Hospital, Department of Neurosurgery, Istanbul, Turkey.

出版信息

Turk Neurosurg. 2017;27(3):353-361. doi: 10.5137/1019-5149.JTN.16400-15.1.

Abstract

AIM

Factors affecting the development of postoperative hydrocephalus patients who underwent surgery after aneurysmal subarachnoid hemorrhage were retrospectively assessed.

MATERIAL AND METHODS

201 cases, who underwent aneurysm surgery in our clinic after subarachnoid hemorrhage between 2008 and 2013, were retrospectively assessed. Twenty-one cases with hydrocephalus development were retrospectively examined according to their age, gender, history (hypertension, alcohol, and smoking), blood type, the number and size of aneurysms, aneurysm localization, the presence of ventricular hemorrhage, baseline-final neurological diagnosis, Fisher grading system, history of vasospasm and meningitis. The initial neurological course and Hunt-Hess, and also final neurological course of the patients were evaluated according to World Federation of Neurosurgical Societies (WFNS) Grading Scale.

RESULTS

Age, history of hypertension, aneurysm localization, Hunt-Hess grading, vasospasm, meningitis and Glasgow Outcome Scale (GOS) are determinative factors in hydrocephalus development due to subarachnoid hemorrhage. It was detected that gender, alcohol and tobacco use, blood group, the size and the number of aneurysm, the presence of intraventricular hemorrhage and Fisher grading were not the determinative factors in the patients.

CONCLUSION

In patients who underwent surgery for subarachnoid hemorrhage, risk factors for postoperative hydrocephalus should be determined and the patients with these risk factors should be closely monitored.

摘要

目的

回顾性评估影响动脉瘤性蛛网膜下腔出血术后脑积水患者病情发展的因素。

材料与方法

回顾性评估2008年至2013年间在我院接受蛛网膜下腔出血后动脉瘤手术的201例患者。对21例发生脑积水的患者,根据其年龄、性别、病史(高血压、饮酒和吸烟)、血型、动脉瘤数量和大小、动脉瘤位置、脑室出血情况、基线-最终神经诊断、Fisher分级系统、血管痉挛和脑膜炎病史进行回顾性检查。根据世界神经外科协会联盟(WFNS)分级量表评估患者的初始神经病程及Hunt-Hess分级,以及患者的最终神经病程。

结果

年龄、高血压病史、动脉瘤位置、Hunt-Hess分级、血管痉挛、脑膜炎和格拉斯哥预后量表(GOS)是蛛网膜下腔出血所致脑积水发展的决定性因素。研究发现,性别、饮酒和吸烟情况、血型、动脉瘤大小和数量、脑室内出血情况及Fisher分级并非这些患者的决定性因素。

结论

对于接受蛛网膜下腔出血手术的患者,应确定术后脑积水的危险因素,并对具有这些危险因素的患者进行密切监测。

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