| 肖庆,焦汝开,周焜,等.血管内介入治疗颅内破裂动脉瘤 82例预后及复发的影响因素分析[J].安徽医药,2021,25(8):1524-1529. |
| 血管内介入治疗颅内破裂动脉瘤 82例预后及复发的影响因素分析 |
| Analysis of factors affecting the prognosis and recurrence of intracranial ruptured aneu? rysms treated by intravascular interventional therapy |
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| DOI：10.3969/j.issn.1009-6469.2021.08.011 |
| 中文关键词: 颅内动脉瘤 栓塞，治疗性 支架 血管内介入治疗 预后 复发 影响因素 |
| 英文关键词: Intracranial aneurysm Embolization,therapeutic Stents Endovascular treatment Prognosis Recurrence In fluencing factors |
| 基金项目:四川省科技支撑计划项目( 2016FZ0073) |
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| 中文摘要: |
| 目的探讨血管内介入治疗颅内破裂动脉瘤预后及动脉瘤复发的影响因素。方法对 2016年 1月至 2018年 9月在贵阳市第二人民医院接受血管内介入治疗的 82例颅内破裂动脉瘤的病人临床资料进行回顾性分析。收集病人临床资料及随访至 2019年 10月 18日前的随访资料，分析各因素对预后及复发的影响。结果 82例中预后良好者 65例(79.27%)； 82例中复发 6例( 7.32%)。单因素分析结果显示:病人年龄、 Hunt-Hess分级、高血压病、动脉瘤位置、手术离发病时间、多发性动脉瘤及 CT Fisher分级、栓塞程度的不同，颅内破裂动脉瘤预后差异有统计学意义( P<0.05)。血管内介入治疗颅内破裂动脉瘤病人年龄、 Hunt-Hess分级、糖尿病、高血压病、动脉瘤直径、瘤颈宽度、动脉瘤位置、手术离发病时间、多发性动脉瘤、 CT Fisher分级、手术方式及栓塞程度的不同，复发率差异有统计学意义( P<0.05)。多因素分析结果显示:年龄 ≥60岁、 Hunt-Hess分级 ≥Ⅲ级、高血压病、手术离发病时间 ≥4 d、多发性动脉瘤、单纯弹簧圈栓塞或单纯支架治疗为颅内破裂动脉瘤预后不良的危险因素，与不全栓塞相比，完全栓塞或瘤颈残留为保护因素。年龄 ≥60岁、 Hunt-Hess分级 ≥Ⅲ级、糖尿病、高血压病、动脉瘤直径 ≥4 mm、瘤颈宽度 ≥5 mm、手术离发病时间 ≥4 d、多发性动脉瘤、 CT Fisher分级 ≥Ⅱ级、单纯弹簧圈栓塞或单纯支架治疗为颅内破裂动脉瘤复发的危险因素，相对于不全栓塞，完全栓塞或瘤颈残留为保护因素(P>0.05)。结论血管内介入治疗颅内破裂动脉瘤预后与年龄、 HuntHess分级、高血压病、手术离发病时间、多发性动脉瘤、 CT Fisher分级及栓塞程度有关。动脉瘤复发与年龄、 Hunt-Hess分级、糖尿病、高血压病、动脉瘤直径、瘤颈宽度、手术离发病时间、多发性动脉瘤、 CT Fisher分级、手术方式及栓塞程度有关，临床上应注意上述因素的影响，尽量完全栓塞以降低复发率，术后积极干预影响动脉瘤复发的影响因素，改善预后及降低复发率。 |
| 英文摘要: |
| Objective To analyze the influencing factors of prognosis and recurrence of intracranial ruptured aneurysm treated byintravascular interventional therapy.Methods A retrospective analysis of 82 cases of intracranial ruptured aneurysms treated with endovascular intervention in Guiyang Second People's Hospital from January 2016 to September 2018 was performed. The patient's clinical data and follow-up data until October 18, 2019 were collected and the effects of various factors on the prognosis and recurrence ofthe patients were analyzed.Results Of the 82 patients, 65 had a good prognosis (79.27%) and 6 had recurrence (7.32%). The resultsof univariate analysis showed that there were statistically significant differences in the prognosis of different intracranial ruptured aneurysms (P < 0.05) in age, Hunt-Hess grade, hypertension, aneurysm location, time from operation, multiple aneurysms, CT Fisher gradeand degree of embolization. There were significant differences in recurrence rate among patients with ruptured intracranial aneurysmtreated by intravascular therapy (P < 0.05). The results of multivariate analysis showed that age ≥ 60 years old, hunt Hess grade ≥ Ⅲ,hypertension, time from operation ≥ 4D, multiple aneurysms, simple coil embolization or stent therapy were the risk factors for poorprognosis of ruptured intracranial aneurysms, and complete embolization or residual tumor neck were the protective factors. Age ≥ 60 years old, hunt Hess grade ≥ Ⅲ, diabetes mellitus, hypertension, aneurysm diameter ≥ 4mm, tumor neck width ≥ 5mm, operationtime ≥ 4D, multiple aneurysms, CT Fisher grade ≥ Ⅱ, simple coil embolization or simple stent therapy were risk factors for recurrenceof ruptured intracranial aneurysm, complete embolization or tumor neck residue are protective factors (P>0.05).Conclusion The prognosis of intracranial ruptured aneurysms treated by intravascular therapy is related to age, hunt Hess grade, hypertension, time from operation, multiple aneurysms, CT Fisher grade and embolism. The recurrence of this disease is related to age, hunt Hess grade, diabetes,hypertension, diameter of aneurysm, width of aneurysm neck, time from operation, multiple aneurysms, CT Fisher grade The operationmode is related to the embolic condition. We should pay attention to the influence of the above factors and take corresponding measuresto reduce the recurrence rate and improve the prognosis. |
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