摘要
目的探讨颅内动脉瘤(intracranial aneurysm,IA)显微夹闭手术并发症与预后的关系,分析IA预后的影响因素。方法收集130例IA患者,记录其手术时间、术中出血量、及术中并发症等情况,对患者预后的影响因素进行Logistic回归分析。结果动脉瘤成功夹闭率为96.4%,Hunt-Hess分级为Ⅳ级的患者脑血管痉挛、动脉瘤破裂、脑水肿、脑梗死、颅内感染、严重肺部感染发生率明显高于Ⅰ~Ⅲ级的患者,Ⅲ级的患者明显高于Ⅰ~Ⅱ级患者(P<0.05)。无并发症的IA患者预后良好率明显高于有并发症患者(P<0.05)。Logistic回顾分析显示,患者年龄、动脉瘤大小、Hunt-Hess分级、是否合并并发症是其预后影响因素。结论显微夹闭术治疗IA具有好的疗效,夹闭成功率较高,但存在并发症发生的风险,影响患者预后。IA患者预后与其年龄、术前Hunt-Huss分级、动脉瘤大小、是否合并并发症密切相关。
Objective To investigate the relationship between complications of intracranial aneurysm(IA)clipping surgery and its prognosis,andanalyze influence factors of IA prognosis.Methods130patients with IA were collected.The operation time,intraoperative blood loss,intraoperativecomplications were recorded.Logistic regression analysis was performed to evaluate the patient’s prognostic factors.Results The IA clippingsuccess rate was96.4%,the rate of cerebral vasospasm,rupture of aneurysm,cerebral edema,cerebral infarction,intracranial infection,severe pulmonaryinfection among patients whose Hunt-Hess grade wasⅣwere significantly higher than those whose Hunt-Hess grade was I-Ⅲ,those among patientswhose Hunt-Hess grade wasⅢwere significantly higher than those whose Hunt-Hess grade was I-Ⅱ(P<0.05).The prognosis good rateamong IA patients with complications was significantly higher than that among patients without complications(P<0.05).Logistic retrospective analysisshowed that the age,size of aneurysm,Hunt-Hess grade and complication were the prognostic factors.Conclusion Microsurgical clipping treatingIA has a good effect,its clipping success rate is high,but there is a risk of occurrence complications that effect the prognosis of IA patients.IA patient’sprognosis has a close relation to age,preoperative Hunt-Huss grade,size of aneurysm and complication.
作者
苏海涛
王坤
柳爱军
洪有波
李宝
Su Hai-tao;Wang Kun;Liu Ai-jun;Hong You-bo;Li Bao(Neurosurgery department of People's Hospital in cangzhou,Cangzhou,Hebei, 061000, China)
出处
《当代医学》
2017年第9期30-33,共4页
Contemporary Medicine
关键词
颅内动脉瘤
显微夹闭手术
并发症
预后
Intracranial aneurysm
Microsurgery
Complications
Prognosis
