Assessment Of Riskfactors For Subarachnoid Hemorrhage Complicated With Hyponatremia In Aneurysms

Spontaneous subarachnoid hemorrhage is common in clinic,mainly caused by ruptured aneurysm,which constitute as much as 80 percent of clinic practice.However,the mortality of systemic systemic complications caused by aneurysm subarachnoid hemorrhage is high,up to 23%.Complications are particularly common in patients with a large amount of bleeding and poor physical condition,included that electrolyte disorders,systemic hypertension,gastrointestinal bleeding,pulmonary edema,pneumonia,acute respiratory distress syndrome,hyperglycemia,deep venous thrombosis and pulmonary edema.The electrolyte is mainly manifested by hyponatremia,seen in 35% patients,in 4-10 days after the onset,mostly occur in the previous traffic aneurysm.Hyponatremia which result from subarachnoid hemorrhage may increase the severity of the disease.The mechanism think that hyponatremia may aggravate brain edema and aggravate local cerebral ischemia.Research statistics found that the mortality rate of patients with hyponatremia and hyponatremia were respectively 43.2% and 20.2%.The mortality and deterioration rate of mild hyponatremia and severe hyponatremia were 25% and 57.1%,respectively.The purpose of this study is to investigate the risk factors for bleeding hyponatremia in patients with aneurysmal subarachnoid,and quantitative analysis of the risk factors,predict the probability of hyponatremia in one week or so,more intuitive to guide the clinical work,decrease complications,shorten the hospitalization days of patients,improve the cure rate.Research method: Retrospective analysis of more than 150 cases of spontaneous subarachnoid hemorrhage in Qianfo Hill Hospital Affiliated to Shandong University from October in 2016 to October in 2017.In 4 day to 8 day,according to the detection of patients with electrolyte extraction,sodium level,and we divide these dates into low sodium group(Na+ < 135mmol/L),and the normal sodium group(135mmol/L < Na+ < 155mmol/L).All risk factors that may affect hyponatremia are recorded.Logistic regression analysis and single factor analysis were used to determine the risk factors for 4-8 days of hyponatremia in the patients.All data processing in this study used SPSS(Version 20)for data processing;when P<0.05,the results were statistically significant.Finally,according to the results of the analysis,to set up a clinical score scale.The results: By single factor analysis,the 4-10 day risk factors for hyponatremia were Hunt-Hess classification(P<0.01),age(P<0.05),aneurysm site(P<0.01),Fisher classification(P<0.01),BNP(P<0.05)and sex(P<0.001).Logistic regression analysis showed that the risk factors for hyponatremia in patients with subarachnoid hemorrhage were Hunt-Hess grading(P<0.01),age(P<0.05),aneurysm location(P<0.01),Fisher grading(P<0.01),BNP(P<0.05)and gender(P<0.001).According to the results of the analysis,to set up a clinical score scale.There were 28 patients with statistical scores of 0-6 points,10 patients with hyponatremia(35.7%),48 patients with 6-12 points,and 32 patients with hyponatraemia.The incidence rate was 66.7%.There were 32 patients with more than 12 points and 24 patients with hyponatremia.The incidence was 75%.Research conclusion: The hyponatremia risk score is a simple and practical scoring scale,which can be used to predict the incidence of hyponatremia on the 4-8 day of subarachnoid hemorrhage.So as to guide doctors to give timely and preventive treatment,reduce the corresponding complications.But for the scale effectiveness need further prospective study.