贵州医科大学学报

2018, v.43;No.213(06) 694-697+720

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影响前交通动脉瘤夹闭术术后患者预后的相关因素
Analysis of Prognostic Factors of Anterior Communicating Artery Aneurysm Clipping

张自豪;吴志宝;张文亮;高普;刘亮;
ZHANG Zihao;WU Zhibao;ZHANG Wenliang;GAO Pu;LIU Liang;Department of Neurosurgery,Hebei Province Seventh People's Hospital;

摘要(Abstract):

目的:探讨影响前交通动脉瘤夹闭术术后患者预后的相关因素。方法:行前交通动脉瘤夹闭术治疗的前交通动脉瘤患者60例,根据患者术后1个月时的格拉斯哥预后量表(GOS)评分将患者分为预后良好组(n=41)和预后不良组(n=19);收集2组患者性别、年龄、合并症、发病至手术时间、动脉瘤直径、动脉瘤走向、术前动脉瘤破裂、术前Hunt-Hess分级、术后脑梗死、术后脑血管痉挛发生情况进行单因素Logistic回归分析,将组间有差异的指标进行多因素非条件Logistic回归分析,探讨影响前交通动脉瘤夹闭术术后患者预后的相关因素。结果:2组患者动脉瘤直径、术前动脉瘤破裂与否、术前Hunt-Hess分级及术后脑血管痉挛与否指标比较,差异具有统计学意义(P<0.05或P<0.01);多因素非条件Logistic回归分析发现,动脉瘤直径>1.5 cm、术前动脉瘤破裂、Hunt-Hess分级Ⅳ~Ⅴ级、术后脑血管痉挛是前交通动脉瘤夹闭术术后患者预后不良的危险因素(P<0.05或P<0.01)。结论:动脉瘤直径>1.5 cm、术前动脉瘤破裂、术前Hunt-Hess分级Ⅳ~Ⅴ级及术后脑血管痉挛是影响前交通动脉瘤夹闭术术后患者预后的危险因素。
Objective: To explore the prognostic factors of the anterior communicating aneurysms clipping. Methods: A total of 60 patients treated with anterior communicating aneurysms clipping were divided into good prognosis group( n = 41) and poor prognosis group( n = 19) according to Glasgow Outcome Scale( GOS) 1 month after operation. Information of Patients' gender,age,complications,time from onset to surgey,diameter of aneurysm,direction of aneurysm,rupture of aneurysm before operation,scale of Hunt-Hess before operation,postoperative cerebral infarction and occurence of postoperative cerebral vasospasm were collected and analyzed by univariate logistic regression analysis.Then multivariate non-conditional logistic regression analysis was used to study the indexes with differences between the two groups,and prognostic factors of patients undergoing anterior communicating aneurysm clipping were discussed. Results: Comparisons about Diameter of aneurysm,rupture of aneurysm before operation,scale of Hunt-Hess before operation and occurence of posoperative cerebral vasospasm showed statistical significance( P < 0. 05 or P < 0. 01). Multivariate non-conditional logistic regression analysis showed that the aneurysm diameter greater than 1. 5 cm,rupture of aneurysms before operation,scale of Hunt-Hess from ⅣtoⅤ,and cerebral angiospasm after operation were risk factors of poor prognosis of patients with anterior communicating aneurysmswith clipping( P < 0. 05 or P <0. 01). Conclusions: Aneurysm diameter greater than 1. 5 cm,rupture of aneurysms before operation,scale of Hunt-Hess from ⅣtoⅤ,and cerebral angiospasm after operation were risk factors of poor prognosis of patients with anterior communicating aneurysmswith clipping.

关键词(KeyWords): 前交通动脉瘤;前交通动脉瘤夹闭术;Hunt-Hess分级;预后;危险因素
anterior communicating aneurysms;anterior communicating aneurysms clipping;Hunt-Hess Scale;prognosis;risk factors

Abstract:

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基金项目(Foundation): 河北省2016医学科学研究重点课题计划(20160409)

作者(Author): 张自豪;吴志宝;张文亮;高普;刘亮;
ZHANG Zihao;WU Zhibao;ZHANG Wenliang;GAO Pu;LIU Liang;Department of Neurosurgery,Hebei Province Seventh People's Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2018.06.016

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