自发性蛛网膜下腔出血继发癫痫发作的危险因素和预后分析

目的探讨自发性蛛网膜下腔出血（sAH）继发癫痫发作的危险因素及预后。方法回顾性分析近10年来河北联合大学附属开滦总医院收治的158例自发性SAH的临床资料。结果158例自发性SAH病人中23例出现癫痫发作，发生率为14．6％。自发性SAH继发癫痫发作组的FisherSAH等级评分3和4分的发生率高于无癫痫发作组（P〈O．05）。癫痫发作组中Rankin评分〉3分或死亡的发生率高于无癫痫发作组（P〈0．05）。结论较高的FisherSAH等级评分是预测自发性SAH继发癫痫发作的危险因素。自发性SAH继发癫痫发作预后不良。自发性SAH继发癫痫的抗癫痫治疗时应充分权衡癫痫的预后及药物所致的副作用，FisherSAH等级评分较高的病人给予预防性抗癫痫治疗可能会更好的改善预后。

Risk factors and Prognosis of Seizures after Spontaneous Subarachnoid Hemorrhage

Objective This study aimed to investigate the risk factors and prognosis of seizures after spontaneous subarachnoid hemorrhage（SAH）. Methods A total of 158 patients with spontaneous SAH were enrolled in this ten year retrospective study. Results Seizures occurred in 23 patients with SAH was accounting for 14. 6~. The fre- quency of 3 and 4 of Fisher SAH Grade in the group with seizures were higher than that without seizures （P~ 0.05 ）. The frequency of Rankin grade ~3 or death in the group with seizures were higher than that without seizures （P-~0.05）. Conclusion Higher Fisher SAH Grade on presentation was predictive of seizure. Spontaneous SAH with seizures had unfavourable prognosis. Regarding potential side-effects of anti-epileptic drugs, anti-epileptic ther- apy should be carefully administered to patients with seizures after spontaneous SAH. Fine prognosis will be proba- bly achieved if the patients with Higher Fisher SAH Grade have been accepted anti-epileptic drugs.