摘要
目的探讨蛛网膜下腔出血(SAH)患者中急性肺损伤或急性呼吸窘迫综合征(ALI/ARDS)的发生率,研究ALI/ARDS发生的危险因素及其对患者预后的影响。方法回顾性分析2018年1月—2021年12月苏州大学附属第一医院收治的167例SAH患者的临床资料。收集患者相关临床资料,多变量Logistic回归模型用于分析影响ALI/ARDS发生以及导致患者不良预后的危险因素。结果167例患者中,有45例发生ALI/ARDS,49例预后不良。在多变量Logistic回归分析中,高龄患者、较低格拉斯哥昏迷(GCS)评分、较高Hunt-Hess分级、较高简化急性生理学评分(SAPS)Ⅱ、误吸、低氧血症和呼吸急促与ALI/ARDS的发病率增加有关。而高Fisher分级、低GCS评分、高Hunt-Hess分级、机械通气时间以及ALI/ARDS则是导致患者不良预后的危险因素。结论ALI/ARDS是SAH患者常见并发症,与神经功能预后不良相关,高龄患者、较低GCS、较高Hunt-Hess分级、较高SAPSⅡ评分、误吸、低氧血症和呼吸急促则是其危险因素。
Objective To study the incidence of acute lung injury or acute respiratory distress syndrome(ALI/ARDS)in patients with subarachnoid hemorrhage(SAH)and to investigate the risk factors for ALI/ARDS occurrence and its impact on patient prognosis.Methods The clinical data of 167 consecutive patients with SAH admitted to the First Hospital of Soochow University from Jan 2018 to Dec 2021 were analyzed retrospectively.Multivariate logistic regression model was used to analyze the risk factors that influence the occurrence of ALI/ARDS and contribute to the poor prognosis of patients.Results Of the 167 patients,45 developed ALI/ARDS and 49 had a poor prognosis.In multivariate logistic regression analysis,elderly patients,lower glasgow coma scale(GCS),higher Hunt-Hess grade,higher simplified acute physiology score(SAPS)II,gastric aspiration,hypoxemia,and tachypnea were associated with an increased incidence of ALI/ARDS.Meanwhile high Fisher's classification,low GCS score,higher Hunt-Hess grade,duration of mechanical ventilation,and ALI/ARDS were risk factors for poor prognosis.Conclusions Development of ALI/ARDS is a common complication in patients with SAH and is independently associated with poor neurological prognosis.Elderly patients,lower GCS,higher Hunt-Hess grade,higher SAPSⅡscore,aspiration,hypoxemia,and tachypnea were risk factors for ALI/ARDS.
作者
高薇
张洪荣
GAO Wei;ZHANG Hongrong(Department of Neurosurgery,The First Affiliated Hospital of Soochow University,Suzhou 215000,China)
出处
《临床神经外科杂志》
2023年第6期630-635,共6页
Journal of Clinical Neurosurgery
基金
苏州市科技发展计划(医疗卫生科技创新-应用基础研究)项目(SKJYD2021079)。
