动脉瘤性蛛网膜下腔出血患者颅内压升高的相关风险因素分析

Analysis of Risk Factors Related to Intracranial Pressure Elevation in Patients with Aneurysmal Subarachnoid Hemorrhage

摘要: 目的：本研究旨在基于临床和影像学特征，预测动脉瘤破裂后出血患者的颅内压变化情况。方法：本研究通过回顾性分析2018年1月至2023年6月在安徽医科大学第二附属医院住院的蛛网膜下腔出血患者，选取57例颅内动脉瘤破裂患者，评估其入院时的Hunt-Hess分级、Fisher分级及SEBES评分，并收集患者的临床资料(包括年龄、性别、合并症如高血压、糖尿病和冠心病)。使用单变量和多变量逻辑回归分析，筛选与临床分级显著相关的因素。结果：在57例患者中，ICP升高组为27例，未升高组为30例。结果显示，Hunt-Hess分级和SEBES评分与颅内压升高独立相关(P < 0.05)，而其他临床和影像学特征与ICP升高无显著相关性。结论：Hunt-Hess分级与SEBES评分与颅内压升高独立相关，这为动脉瘤风险评估和临床治疗提供了提供有价值的信息。

Abstract: Objective: To predict intracranial pressure (ICP) changes after aneurysm rupture and hemorrhage based on clinical and imaging features. Methods: A retrospective analysis was conducted on hospitalized patients diagnosed with subarachnoid hemorrhage at the Second Hospital of Anhui Medical University from January 2018 to June 2023. Fifty-seven cases of ruptured intracranial aneurysms were selected, and the Hunt-Hess grade, Fisher grade, and SEBES score were assessed at admission. Clinical data were collected, including age, gender, and comorbidities such as hypertension, diabetes, and coronary heart disease. Univariate and multivariate logistic regression analyses were used to screen factors significantly associated with clinical grading. Results: Among the 57 patients, 27 were in the elevated ICP group, and 30 were in the non-elevated group. Hunt-Hess grade and SEBES score were independently associated with elevated ICP (P < 0.05), while other clinical and imaging features were not significantly correlated with ICP elevation. Conclusion: Fisher grade and Hunt-Hess grade are independently associated with elevated ICP, providing valuable information for aneurysm risk prediction and clinical diagnosis and treatment.