Risk factors and intervention strategies for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage
动脉瘤性蛛网膜下腔出血后迟发性脑缺血的危险因素与干预策略

摘要

目的 探究分析动脉瘤性蛛网膜下腔出血后迟发性脑缺血的危险因素与干预策略。方法 回顾性分析2024年1月至2024年12月期间，院内62例动脉瘤性蛛网膜下腔出血患者病例资料。将患者年龄，性别，改良Fisher分级，Hunt-Hess分级，合并症以及临床检查结果等资料纳入单因素以及多因素Logistic回归分析，明确动脉瘤性蛛网膜下腔出血后迟发性脑缺血的危险因素。结果 在62例患者中，存在9例患者出现脉瘤性蛛网膜下腔出血后迟发性脑缺血，53例患者未出现脉瘤性蛛网膜下腔出血后迟发性脑缺血。单因素分析结果显示：Hunt-Hess分级，改良Fisher分级，合并肺部感染，高血压病均属于脉瘤性蛛网膜下腔出血后迟发性脑缺血的相关因素，P＜0.05。多因素Logistic回归分析显示：Hunt-Hess分级高级别，改良Fisher分级高级别，合并肺部感染属于动脉瘤性蛛网膜下腔出血后迟发性脑缺血的危险因素，P＜0.05。结论 脉瘤性蛛网膜下腔出血后迟发性脑缺血的危险因素呈现出多样化的特点，需及时落实针对性干预策略，以最大程度的改善患者病情状态及预后。

Abstract

Objective To explore and analyze the risk factors and intervention strategies for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.
Methods A retrospective analysis was conducted on the case data of 62 patients with aneurysmal subarachnoid hemorrhage admitted to the hospital from January 2024 to December 2024. Include patient age, gender, modified Fisher grading, Hunt Hess grading, comorbidities, and clinical examination results in univariate and multivariate logistic regression analysis to identify risk factors for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Among the 62 patients, 9 patients experienced delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage, while 53 patients did not experience delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. The results of univariate analysis showed that Hunt Hess grading, modified Fisher grading, combined pulmonary infection, and hypertension were all related factors to delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage, P＜0.05. Multivariate logistic regression analysis showed that high Hunt Hess and modified Fisher classifications, combined with pulmonary infection, are risk factors for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage, P＜0.05.
Conclusion   The risk factors for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage exhibit diverse characteristics, and targeted intervention strategies need to be implemented in a timely manner to maximize the improvement of the patient's condition and prognosis.