自发性蛛网膜下腔出血并发脑积水的危险因素和临床特征分析

目的：分析自发性蛛网膜下腔出血（spontaneoussubarachnoidheinorrhage。sSAH）患者发生脑积水的危险因素，并探讨其临床特点、治疗方法及疗效。方法：选取南通大学附属医院神经外科2003年1月-2013年12月间收治的的356例sSAH患者．对其中51例sSAH并发脑积水患者的临床资料进行回顾性分析。结果：影响sSAH并发脑积水的高危因素主要有Hurt-Hess分级、Fish分级、动脉瘤部位、反复多次出血等。51例患者分别实施脑室外引流术、V-P分流术后，经GOS评分：良好25例，轻度残疾16例，中度残疾7例，重度残疾3例。结论：在临床治疗中根据患者病情早期选取介入栓塞或者开颅手术治疗方案并配合使用相对应的引流术．可降低术后患者的致残率．提高临床治疗效果。

Analysis of clinical characteristic and risk factors of hydrocephalus after spontaneous subarachnoid hemorrhage

Objective To analyze spontaneous subarachnoid hemorrhage（sSAH） risk factors of hydrocephalus in patientswith, and to explore its clinical characteristics, treatment methods and curative effect of progress. Methods： 356 sSAH pa-tients were randomly selected from our hospital neurosurgery in January 2003 to December 2013, including 51 concurrent hy-drocephalus patients,whose clinical diagnosis and treatment data were analyzed retrospectively. Results： Trigger sSAH con-current main risk factors of hydrocephalus： Hunt-Hess classification, Fish classification and aneurysm location, repeatedhemorrhage and so on. 51 patients were treated with the implementation of ventricle drainage or V-P bypass surgery, whoseGCS score showed that 25 cases recovered well, 16 cases were mild invalid, 7 cases were moderate disabled, severely dis-abled for 3 cases. Conclusions： Long-term clinical studies had confirmed that the sSAH concurrent hydrocephalus diseaseprevention first need to start from the early onset of treatment, and during the whole therapy performed preventive treatmenttheory. According to the patients in the clinical treatment of selected interventional embolization or surgical operation treat-ment and drainage, together with the corresponding in order to reduce the morbidity of postoperative patients and to improvethe clinical therapeutic effect.