中华临床医师杂志(电子版) 2017年2月,11卷4期

综 述

动脉瘤性蛛网膜下腔出血再出血危险因素的探讨

陈风 赵学明

030001 太原,山西医科大学1;030001 太原,山西医科大学第一医院神经外科2
赵学明,Email: 304918895@qq.com

摘要: 动脉瘤性蛛网膜下腔出血再出血是动脉瘤患者致残及死亡的一个主要原因,术前积极地预防动脉瘤性蛛网膜下腔出血再出血对患者预后起着至关重要的作用。目前对于动脉瘤性蛛网膜下腔出血再出血危险因素的研究较多,本文将对可能导致动脉瘤性蛛网膜下腔出血再出血的危险因素进行阐述,指出当前争论焦点,分析研究中可能存在的问题,并对未来的研究趋势进行展望。

关键词:蛛网膜下腔出血; 危险因素; 再出血

Discussion of risk factors for rebleeding of aneurysmal subarachnoid hemorrhage

Chen Feng1, Zhao Xueming2.

1Shanxi Medical University, Taiyuan 030001, China; 2Department of Neurosurgery, the First Hospital of Shanxi Medical University, Taiyuan 030001, China
Zhao Xueming, Email: 304918895@qq.com

Abstract:Rebleeding of aneurysmal subarachnoid hemorrhage is a major cause of disability and death in patients, active prevention of rebleeding of aneurysmal subarachnoid hemorrhage before operation plays an important role in the prognosis of patients. At present, there are many studies on the risk factors of rebleeding of aneurysmal subarachnoid hemorrhage, our study would set out the risk factors that may result in the rebleeding of aneurysmal subarachnoid hemorrhage, point out the current debate focus , analyze the possible problems in the research and prospect the future research.

Keywords:Subarachnoid hemorrhage; Risk factors; Rebleeding

+ 字体 -

参考文献

  [1] Rosengart AJ, Schultheiss KE, Tolentino J, et al. Prognostic factors for outcome in patients with aneurysmal subarachnoid hemorrhage [J]. Stroke, 2007, 38(8): 2315-2321.

  [2] Larsen CC, Astrup J. Rebleeding after aneurysmal subarachnoid hemorrhage: a literaturereview[J]. World Neurosurg, 2013, 79(2): 307-312.

  [3] Zhao L, Zhang L, Zhang X, et al. An analysis of 1 256 cases of sporadic ruptured cerebral aneurysm in a single Chinese institution [J]. PLoS One, 2014, 9(1): e85668.

  [4] Linn FH, Wijdicks EF, van der Graaf Y, et al. Prospective study of sentinel headache in aneurysmal subarachnoid haemorrhage[J]. Lancet, 1994, 344(8922): 590-593.

  [5] Jakobsson KE, Saveland H, Hillman J, et al. Warning leak and management outcome in aneurysmal subarachnoid hemorrhage[J]. Neurosurg, 1996, 85(6): 995-999.

  [6] Beck J, Raabe A, Szelenyi A, et al. Sentinel headache and the risk of rebleeding after aneurysmal subarachnoid hemorrhage[J]. Stroke, 2006, 37(11): 2733-2737.

  [7] Naidech AM, Janjua N, Kreiter KT, et al. Predictors and impact of aneurysm rebleeding after subarachnoid hemorrhage[J]. Arch Neurol, 2005, 62(3): 410-416.

  [8] Fujii Y, Takeuchi S, Sasaki O, et al. Ultra-early rebleeding in spontaneous subarachnoid hemorrhage[J]. J Neurosurg, 1996, 84(1): 35-42.

  [9] Oda S, Shimoda M, Hirayama A, et al. Neuroradiologic Diagnosis of Minor Leak prior to Major SAH: Diagnosis by T1-FLAIR Mismatch[J]. AJNR Am J Neuroradiol, 2015, 36(9): 1616-1622.

  [10] Solanki C, Pandey P, Rao KV. Predictors of aneurysmal rebleed before definitive surgical or endovascular management[J]. Acta Neurochir(Wien), 2016, 158(6): 1037-1044.

  [11] Guo LM, Zhou HY, Xu JW, et al. Risk factors related to aneurysmal rebleeding[J]. World Neurosurg, 2011, 76(3/4): 292-298.

  [12] De Marchis GM, Lantigua H, Schmidt JM, et al. Impact of premorbid hypertension on haemorrhage severity and aneurysm rebleeding risk after subarachnoid haemorrhage[J]. J Neurol Neurosurg Psychiatry, 2014, 85(1): 56-59.

  [13] Jaja BN, Lingsma H, Schweizer TA, et al. Prognostic value of premorbid hypertension and neurological status in aneurysmal subarachnoid hemorrhage: pooled analyses of individual patient data in the SAHIT repository[J]. J Neurosurg, 2015, 122(3): 644-652.

  [14] Oheda M, Inamasu J, Moriya S, et al. Early rebleeding in patients with subarachnoid haemorrhage under intensive blood pressure management[J]. J Clin Neurosci, 2015, 22(8): 1338-1342.

  [15] Sykora MM, Diedler JM, Rupp AP, et al. Impaired baroreceptor sensitivity predicts outcome inacute intracerebral haemorrhage[J]. Crit Care Med, 2008, 36(11): 3074-3079.

  [16] Tanaka E, Koga M, Kobayashi J, et al. Blood pressure variability on antihypertensive therapy in acute intracerebral hemorrhage: the Stroke Acute Management with Urgent Risk factor Assessment and Improvement intracerebral hemorrhage study[J]. Stroke, 2014, 45(8): 2275-2279.

  [17] Lin QS, Ping-Chen, Lin YX, et al. Systolic blood pressure variability is a novel risk factor for rebleeding in acute subarachnoid hemorrhage: a case-control study[J]. Medicine(Baltimore), 2016, 95(11): e3028.

  [18] 刘建明, 冯华, 李天晓, 等. 中国动脉瘤性蛛网膜下腔出血诊疗指导规范(2016年)[J]. 全科医学临床与教育, 2016, 14(4): 363-368.

  [19] Machiel Pleizier C, Algra A, Velthuis BK, et al. Relation between size of aneurysms and risk of rebleeding in patients with subarachnoid haemorrhage[J]. Acta Neurochir(Wien), 2006, 148(12): 1277-1279.

  [20] Shiue I, Arima H, Hankey GJ, et al. Location and size of ruptured intracranial aneurysm and serious clinical outcomes early after subarachnoid hemorrhage: a population-based study in Australasia[J]. Cerebrovasc Dis, 2011, 31(6): 573-579.

  [21] Wu TC, Tsui YK, Chen TY, et al. Rebleeding of aneurysmal subarachnoid hemorrhage in computed tomography angiography: risk factor, rebleeding pattern, and outcome analysis[J]. J Comput Assist Tomogr, 2012, 36(1): 103-108.

  [22] Tang C, Zhang TS, Zhou LF. Risk factors for rebleeding of aneurysmalsubarachnoid hemorrhage: a meta-analysis[J]. PLoS One, 2014, 9(6): e99536.

  [23] Boogaarts HD, van Lieshout JH, van Amerongen MJ, et al. Aneurysm diameter as a risk factor forpretreatment rebleeding: a meta-analysis[J]. J Neurosurg, 2015, 122(4): 921-928.

  [24] Rivero Rodríguez D, Scherle Matamoros C, Fernández Cúe L, et al. Re-bleeding predictors in patients with aneurysmal subarachnoid haemorrhage and delayed neurosurgical treatment[J]. Neurocirugia (Astur), 2016, 27(2): 51-56.

  [25] Cha KC, Kim JH, Kang HI, et al. Aneurysmal rebleeding: factors associated with clinical outcome in the rebleeding patients[J]. J Korean Neurosurg Soc, 2010, 47(2): 119-123.

  [26] Cong W, Zhongxin Z, Tiangui L, et al. Risk factors for rebleeding of aneurysmal subarachnoid hemorrhage based on the analysis of on-admission information[J]. Turk Neurosurg, 2012, 22(6): 675-681.

  [27] Ohkuma H, Tsurutani H, Suzuki S. Incidence and significance of early aneurysmal rebleeding before neurosurgical or neurological management[J]. Stroke, 2001, 32(5): 1176-1180.

  [28] Naidech AM, Janjua N, Kreiter KT, et al. Predictors and impact of aneurysm rebleeding after subarachnoid hemorrhage[J]. Arch Neurol, 2005, 62(3): 410-416.

  [29] van Donkelaar CE, Bakker NA, Veeger NJ, et al. Predictive Factors for Rebleeding After Aneurysmal Subarachnoid Hemorrhage: Rebleeding Aneurysmal Subarachnoid Hemorrhage Study[J]. Stroke, 2015, 46(8): 2100-2106.

  [30] Larsen CC, Srensen B, Nielsen JD, et al. Reduced clot-stability during the first 6 hours after aneurysmal subarachnoid haemorrhage-a prospective case-control study[J]. Thromb Res, 2012, 129(5): e229-232.

  [31] Brilstra EH, Rinkel GJ, Algra A, et al. Rebleeding, secondary ischemia, and timing of operation in patients with subarachnoid hemorrhage[J]. Neurology, 2000, 55(11): 1656-1660.

(编辑:张志巍 收稿日期:2016-11-02)