动脉瘤性蛛网膜下腔出血患者认知功能影响因素研究

目的研究动脉瘤性蛛网膜下腔出血（SAH）患者认知功能的动态变化及其影响因素。方法以简易智能量表评估入院时、出院时和出院后2个月患者的认知功能;以Hunt-Hess、GCS、手术方式、GOS、年龄、性别和入院时并发症为变量,研究其与SAH患者认知功能间的关系。结果 100例动脉瘤性SAH患者认知功能损害率入院时为37%,出院时60%,出院后2个月38%;出院时认知功能损害率高于入院时（χ2=10.590,P=0.001）和出院后2个月（χ2=9.684,P=0.002）;对出院时认知功能有显著影响的因素是Hunt-Hess、GOS和手术方式,对出院后2个月认知功能有显著影响的因素是GOS。结论动脉瘤性蛛网膜下腔出血患者存在一定程度的认知功能损害,并与一定的影响因素相关;血管内治疗有助于减轻认知功能的损害。

Factors influencing cognitive function in patients with aneurismal subarachnoid hemorrhage

Objective To investigate the changes of cognitive function and its influencing factors in patients with aneurismal subarachnoid hemorrhage （SAH）.Methods The cognitive function of patients was evaluated by mini-mental state examination at admission,discharge and 2 months post-discharge. The influencing factors related to cognitive function including Hunt-Hess grade,Glasgow coma score （GCS）,operative methods,Glasgow outcome scale （GOS）,age,gender and complications were analyzed.Results The incidence of cognitive impairment in 100 patients with aneurismal SAH was 37% at admission,60% at discharge and 38% at 2 months post-discharge,respectively. The incidence of cognitive impairment was higher at discharge than admission（χ2=10.590,P=0.001） and 2 months post-discharge（χ2=9.684,P=0.002）,respectively. Hunt-Hess grade,GOS and surgical options imposed obvious effect on cognitive impairment at discharge,while GOS had impact on cognitive function at 2 months post-discharge.Conclusion Cognitive impairment generally appears in the patients with aneurismal SAH,which is associated with certain factors. Endovascular treatment contributes to the relief of cognitive impairment.