文章摘要
郭鸣, ，李冰洁, ，梅利平, ，赵军, ，周昊,.动脉瘤性蛛网膜下腔出血患者Hunt-Hess分级与并发症及功能障碍相关性分析[J].神经损伤功能重建,2024,(4):217-221
动脉瘤性蛛网膜下腔出血患者Hunt-Hess分级与并发症及功能障碍相关性分析
Correlation Analysis of Hunt-Hess Grading with Complications and Dysfunction in Patientswith Aneurysmal Subarachnoid Hemorrhage
  
DOI：
中文关键词: 动脉瘤性蛛网膜下腔出血  Hunt-Hess分级  并发症  功能障碍  脑积水
英文关键词: aneurysmal subarachnoid hemorrhage  Hunt-Hess  complications  dysfunction  hydrocephalus
基金项目:国家重点研发计划 （中国老年失能预 防与干预管理网络 及 技 术 研 究 ，No. 2020YFC2008500； 老年失能综合康复 评估及管理模式研 究，No. 2020YFC20 08502）
作者单位
郭鸣1,2 ，李冰洁1,2 ，梅利平1,2 ，赵军1,2 ，周昊1,2 1. 中国康复研究中 心 2. 首都医科大学康 复医学院 
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中文摘要:
      目的：探讨动脉瘤性蛛网膜下腔出血（aneurysmal subarachnoid hemorrhage，aSAH）患者的Hunt-Hess 分级与并发症及神经系统功能障碍的相关性。方法：回顾性分析2011年10月到2021年10月收治的195例 aSAH患者的临床资料，将Hunt-HessⅠ～Ⅲ级纳入低级别组（86例），Ⅳ～Ⅴ级纳入高级别组（109例）。比 较 2 组患者的一般情况、量表评分、并发症及主要功能障碍，并将差异有统计学意义的指标进行多因素 Logistic 回归分析。结果：Hunt-Hess 分级与脑积水（OR 2.850、95%CI 1.560～5.206），运动功能障碍（OR 3.522、95%CI 2.026～6.121），语言功能障碍（OR 1.928、95%CI 1.062～3.500），意识障碍（OR 3.662、95%CI 1.558～8.607），吞咽障碍（OR 2.383、95%CI 1.248～4.550）呈正相关；与年龄（OR 0.970、95%CI 0.945～ 0.996），继发脑梗死（OR 0.414、95%CI 0.227～0.754），Fugl-Meyer 平衡评分（OR 0.890、95%CI 0.818～ 0.968），ADL评分（OR 0.983、95%CI 0.971～0.994）呈负相关。结论：Hunt-Hess高级别组的患者脑积水的发 生比率更高，整体功能障碍更重，年轻患者的存活率更高；但Hunt-Hess级别高低，患者均有认知障碍的风 险，应注意及时筛查并进行个体化康复。
英文摘要:
      To explore the correlation between Hunt-Hess grading and complications as well as neurological dysfunction in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods: Clinical data of 195 aSAH patients treated from October 2011 to October 2021 were retrospectively analyzed. Patients graded I-III on the Hunt-Hess scale were included in the low-grade group (86 cases), and those graded IV-V were included in the high-grade group (109 cases). General conditions, scale scores, complications, and main dysfunctions of patients in both groups were compared, and indicators with significant differences were analyzed using multivariate logistic regression. Results: The Hunt-Hess grading was positively correlated with hydrocephalus (OR 2.850, 95%CI 1.560-5.206), motor dysfunction (OR 3.522, 95%CI 2.026-6.121), language dysfunction (OR 1.928, 95%CI 1.062-3.500), consciousness disorder (OR 3.662, 95%CI 1.558-8.607), and swallowing disorder (OR 2.383, 95%CI 1.248-4.550); it was negatively correlated with age (OR 0.970, 95%CI 0.945-0.996), secondary cerebral infarction (OR 0.414, 95% CI 0.227-0.754), Fugl-Meyer balance score (OR 0.890, 95% CI 0.818-0.968), and ADL score (OR 0.983, 95% CI 0.971-0.994). Conclusion: Patients in the high-grade Hunt-Hess group have a higher incidence of hydrocephalus and more severe overall dysfunction, while younger patients have a higher survival rate; however, regardless of the level of Hunt-Hess grade, patients are at risk of cognitive disorders. Timely screening and individualized rehabilitation should be considered.
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