显微手术治疗颅内动脉瘤后脑血管痉挛和预后的影响因素分析  

Prognosis of intracranial aneurysms after microsurgical treatment and risk of cerebral vasospasm： a relevant factor analysis

作　　者：黄国栋[1] 李维平[1] 付友增[1] 纪涛[1] 高永中[1] 

机构地区：[1]深圳大学第一附属医院(深圳市第二人民医院)神经外科,深圳518035

出　　处：《中华神经医学杂志》2011年第7期705-708,共4页Chinese Journal of Neuromedicine

基　　金：广东省医学科研基金（A2006582）

摘　　要：目的探讨影响显微手术治疗颅内动脉瘤的预后和脑血管痉挛（CVS）发生的相关因素。方法收集深圳市第二人民医院神经外科自2006年6月至2009年5月行显微手术治疗的322例颅内动脉瘤患者的临床资料．Logistic回归分析年龄、性别、血压、血糖、手术时机、Fisher’s分级、Hunt—Hess分级、感染等因素对患者预后及CVS发生的影响。结果多因素Logistic回归分析显示年龄、Hunt—Hess分级、Fisher’s分级、CVS、感染、腰穿次数是影响患者预后的独立危险因素（P〈0．05）；Hunt．Hess分级、Fisher’s分级、动脉瘤数量、终板造瘘、腰穿次数、感染是影响CVS发生的独立危险因素（P〈0．05）。结论年龄、Hunt—Hess分级、Fisher’s分级、CVS、腰穿次数、感染影响患者预后，其中CVS是最重要的影响因素。CVS受Hunt．Hess分级、Fisher＇s分级、动脉瘤数量、终板造瘘、腰穿次数及感染因素影响。Objective To explore the relevant factors of prognosis of intracranial aneurysms after microsurgical treatment and risk factors of cerebral vasospasm （CVS）. Methods Three hundred and twenty-two patients with intracranial aneurysms, admitted to and received surgical treatment in our hospital from June 2006 to May 2009, were chosen in our study; their clinical data were retrospectively analyzed. Logistic regression analysis was employed to analyze the influences of age, gender, blood pressure level, blood sugar level, operation time, Fisher＇s grade, Hunt Hess grade and infection on the prognosis of patients with intracranial aneurysms and the risk of CVS. Results Multivariate logistic analysis indicated that age, Hunt Hess grade, Fisher＇ s grade, CVS, infection and lumber puncture times were the independent risk factors influencing the prognosis of patients with intracranial aneurysms （P〈 0.05）. Hunt Hess grade, Fisher＇ s grade, number of aneurysms, endplate colostomy, lumber puncture times and infection were the independent risk factors of CVS （P〈0.05）. Conclusion Age, Hunt Hess grade, Fisher＇ s grade, CVS, lumber puncture times and infection are the independent risk factors affecting the prognosis of patients with intracranial aneurysms, among which, CVS is the most important factor. CVS is mainly affected by Hunt Hess grade, Fisher＇ s grade, number of aneurysms, endplate colostomy, lumber puncture times and infection.

关 键 词：颅内动脉瘤 蛛网膜下腔出血 显微外科手术 脑血管痉挛 预后 

分 类 号：R743.35[医药卫生—神经病学与精神病学]