Risk factors of chronic hydrocephalus after operation of aneurysmal subarachnoid hemorrhage

Tangmin WEN; Caihua CHEN

doi:10.16016/j.1000-5404.202105114

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Risk factors of chronic hydrocephalus after operation of aneurysmal subarachnoid hemorrhage

Clinical Medicine | 更新时间：2026-01-09

- Risk factors of chronic hydrocephalus after operation of aneurysmal subarachnoid hemorrhage
- Journal of Third Military Medical University Vol. 43, Issue 22, Pages: 2474-2479(2021)
- 作者机构：
  
  401220 重庆，重庆市长寿区人民医院神经外科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.202105114
  CLC： R181.32;R742.7;R743.35
- Received：24 May 2021，
  
  Revised：2021-06-01，
  
  Published：30 November 2021
- 稿件说明：
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Tangmin WEN, Caihua CHEN. Risk factors of chronic hydrocephalus after operation of aneurysmal subarachnoid hemorrhage[J]. Journal of Third Military Medical University, 2021, 43(22): 2474-2479.
DOI：

Tangmin WEN, Caihua CHEN. Risk factors of chronic hydrocephalus after operation of aneurysmal subarachnoid hemorrhage[J]. Journal of Third Military Medical University, 2021, 43(22): 2474-2479. DOI： 10.16016/j.1000-5404.202105114.

摘要

目的

分析动脉瘤性蛛网膜下腔出血术后发生慢性脑积水的独立危险因素。

方法

回顾性分析2014年12月至2020年12月我院神经外科收治的99例动脉瘤性蛛网膜下腔出血患者，查阅病历资料记录患者年龄、性别、烟酒史、高血压病史、出血是否破入脑室、是否合并脑内血肿、动脉瘤位置、发生出血的次数、入院Fisher分级、Hunt-Hess分级、是否行腰大池引流术、是否行脑室外引流、是否颅内感染。99例手术治疗的动脉瘤性蛛网膜下腔出血患者中，发生慢性脑积水30例，未发生脑积水69例，采用单因素和多因素Logistic回归分析筛选发生脑积水的危险因素。

结果

单因素方差分析结果显示：年龄、Fisher分级、Hunt-Hess分级高和多次出血明显增加术后慢性脑积水的发生率（

0.05）。χ

检验结果显示：出血破入脑室、脑内血肿、腰大池引流、脑室外引流以及颅内感染等明显增加慢性脑积水的发生率（

0.05）。二元Logistic回归分析结果显示：动脉瘤性蛛网膜下腔出血术后发生慢性脑积水的独立危险因素有蛛网膜下腔出血破入脑室（

=0.003）、合并脑内血肿（

=0.005）、Hunt-Hess分级较高（

=0.006）、Fisher分级较高（

=0.011）、行脑室外引流（

=0.005）、行腰大池引流（

=0.008）、颅内感染（

=0.039）。

结论

出血破入脑室、合并脑内血肿、高等级的Hunt-Hess与Fisher分级、脑室外引流、腰大池引流、颅内感染等均是动脉瘤蛛网膜下腔出血患者术后发生慢性脑积水的独立危险因素。

Abstract

Objective

To identify the independent risk factors of chronic hydrocephalus in patients after the operation of aneurysmal subarachnoid hemorrhage (aSAH).

Methods

The clinical data of 99 patients with aSAH treated in our hospital from December 2014 to December 2020 were collected and retrospectively analyzed

including age

gender

history of smoking and drinking

hypertension

intraventricular hemorrhage or not

complicated with intracerebral hematoma or not

lumbar cistern drainage

ventricular drainage

intracranial infection or not

location of aneurysm

frequency of hemorrhage

and results of Fisher Grading Scale and Hunt-Hess Classification of SAH. Among the 99 cases of aSAH

30 patients developed postoperative chronic hydrocephalus. Univariate and multivariate logistic regression analysis were performed to screen the risk factors of chronic hydrocephalus.

Results

The results of one-way ANOVA indicated that older age

higher Fisher grade and Hunt-Hess grade

and more bleeding times significantly increased the incidence of postoperative chronic hydrocephalus (

0.05); meanwhile

Chi-square

test showed that intraventricular hemorrhage

intracerebral hematoma

lumbar cistern drainage

ventricular drainage

intracranial infection also resulted in elevated incidence of postoperative chronic hydrocephalus (

0.05). Multiple logistic regression analysis presented that intraventricular hemorrhage (

=0.003)

intracerebral hematoma (

=0.005)

higher Hunt-Hess grade (

=0.006)

higher Fisher grade (

=0.011)

ventricular drainage (

=0.005)

lumbar cistern drainage (

=0.008) and intracranial infection (

=0.039) were independent risk factors of chronic hydrocephalus after aSAH operation.

Conclusion

Intraventricular hemorrhage

intracerebral hematoma

higher Hunt-Hess grade and Fisher grade

lumbar cistern drainage

ventricular drainage

and intracranial infection are independent risk factors of postoperative chronic hydrocephalus in patients with aSAH.

关键词

Keywords

references

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