本文選題：顱內(nèi)動(dòng)脈瘤 + 蛛網(wǎng)膜下腔出血��； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的 探討血液中血紅蛋白濃度對(duì)動(dòng)脈瘤性蛛網(wǎng)膜下腔出血患者外科治療后癥狀性腦血管痙攣發(fā)生的影響。 方法 回顧性分析218動(dòng)脈瘤破裂后行外科手術(shù)治療患者的病案資料，包括一般資料、手術(shù)方式、術(shù)中動(dòng)脈瘤是否破裂、入院時(shí)Hunt-hess分級(jí)等。對(duì)動(dòng)脈瘤破裂后的初次CT結(jié)果進(jìn)行發(fā)發(fā)Fisher分級(jí)，詳細(xì)記錄患者術(shù)后測(cè)得的血紅蛋白濃度并計(jì)算其平均值，將每個(gè)患者術(shù)后的平均血紅蛋白濃度分為110g/L以下、110-120g/L、120-130g/L、130g/L以上四個(gè)等級(jí)。先對(duì)可能影響癥狀性腦血管痙攣的因素進(jìn)行單因素分析，，再將單因素分析有統(tǒng)計(jì)學(xué)意義的因素納入多因素逐步logistic回歸分析。 結(jié)果 1單因素分析提示入院時(shí)Hunt-hess分級(jí)、術(shù)中是否破裂、CTFisher分級(jí)、術(shù)后平均血紅蛋白濃度與患者術(shù)后癥狀性腦血管痙攣的發(fā)生顯著相關(guān)（P0.05）。 2多因素分析提示在調(diào)整了入院時(shí)Hunt-hess分級(jí)、CTFisher分級(jí)混雜作用后，術(shù)后平均血紅蛋白濃度與癥狀性腦血管痙攣的發(fā)生顯著相關(guān)，與其它各等級(jí)相比，術(shù)后平均血紅蛋白濃度在110-120g/L的患者癥狀性腦血管痙攣發(fā)生率最低（OR=3.293、3.633、5.336，P0.05）。 結(jié)論 血紅蛋白濃度是動(dòng)脈瘤性蛛網(wǎng)膜下腔出血患者外科治療后癥狀性腦血管痙攣的一個(gè)獨(dú)立危險(xiǎn)因素，維持血紅蛋白濃度在一定水平有利于減少患者術(shù)后癥狀性腦血管痙攣的發(fā)生。
[Abstract]:Objective to investigate the effect of hemoglobin concentration in blood on the occurrence of symptomatic cerebral vasospasm after surgical treatment in patients with aneurysm subarachnoid hemorrhage. General data, surgical procedures, intraoperative rupture of aneurysms, Hunt-hess grading on admission, etc. The initial CT results of ruptured aneurysms were classified by Fisher grade. The hemoglobin concentrations were recorded and calculated in detail. The mean hemoglobin concentrations of each patient were divided into four grades below 110-120 g / L, 120-130 g / L, 130 g / L and below 110 g / L, respectively. Univariate analysis was carried out to analyze the factors that might affect symptomatic cerebral vasospasm, and then the factors with statistical significance in univariate analysis were included in multivariate stepwise logistic regression analysis. Results 1 single factor analysis suggested Hunt-hess grade on admission. There was a significant correlation between postoperative mean hemoglobin concentration and the occurrence of symptomatic cerebral vasospasm (P 0.05). 2 multivariate analysis showed that after adjusting the mixed effect of Hunt-hess grade and CTFisher grade on admission, the mean hemoglobin concentration was significantly correlated with the occurrence of symptomatic cerebral vasospasm. The mean hemoglobin concentration was significantly correlated with the occurrence of symptomatic cerebral vasospasm, compared with other grades. The incidence of symptomatic cerebral vasospasm was the lowest in patients with postoperative mean hemoglobin concentration of 110-120 g / L. Conclusion hemoglobin concentration is an independent risk factor for symptomatic cerebral vasospasm after surgical treatment in patients with aneurysm subarachnoid hemorrhage. Maintaining hemoglobin concentration at a certain level can reduce the incidence of symptomatic cerebral vasospasm after operation.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.35

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本文編號(hào)：1995844