颅内动脉瘤破裂的患者预后影响因素分析  

Factors influencing outcomes in patients with ruptured intracranial aneurysms

作　　者：李金坤[1] 孙晓娟[2] 吴洪涛[1] 孙广宁[1] 王春平[1] 王增武[3] 

机构地区：[1]潍坊医学院公共卫生学院,261053 [2]潍坊市人民医院职业病科 [3]潍坊市人民医院神经外科

出　　处：《中华老年心脑血管病杂志》2015年第6期613-615,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：山东省医药卫生科技发展计划项目(2011HW086);潍坊市卫生局科研项目(2014069);潍坊市科学技术发展计划(201302082)

摘　　要：目的探讨颅内动脉瘤破裂的患者预后影响因素。方法回顾性分析576例颅内动脉瘤破裂患者的病历资料,对患者的年龄、性别、入院时有无头痛症状、Hunt-Hess分级、手术时机和手术方式等进行单因素和多因素logistic回归分析,根据格拉斯哥预后评分（GOS）评价影响手术预后的相关因素。结果单因素分析结果显示,患者的年龄、入院时有无头痛症状、Hunt-Hess分级、手术时机和手术方式是影响破裂颅内动脉瘤患者预后的影响因素（P〈0.05,P〈0.01）。多因素logistic回归分析显示,年龄（OR=0.329,95%CI：0.144～0.735,P=0.021）、Hunt-Hess分级（OR=1.358,95%CI：2.531～5.622,P=0.002）、手术时机（OR=1.826,95%CI：1.521～2.103,P=0.019）和手术方式（OR=0.428,95%CI：0.246～0.745,P=0.003）是影响破裂颅内动脉瘤患者预后的独立危险因素。结论准确的病情综合分析、最佳的手术时机和正确的手术方式是提高患者预后的关键。Objective To study the factors influencing the outcomes in patients with ruptured intracranial aneurysms.Methods Five hundred and eighty patients with ruptured intracranial aneurysms were included in this study.Their clinical data were retrospectively analyzed by univariate and multivariate logistic regression analysis,including age,gender,headache symptoms at admission,Hunt-Hess classification,surgical time and procedure.Related factors influencing the outcomes in patients after operation were assessed according to the GOS.Results Univarite logistic regression analysis showed that age,headache symptoms at admission,Hunt-Hess classification,and surgical time and procedure were the factors influencing the outcomes in patients with ruptured intracranial aneurysms（P〈0.05,P〈0.01）.Multivariate logistic regression analysis displayed that age,headache symptoms at admission,Hunt-Hess classification,surgical time and procedure were the independent risk factors for the outcomes in patients with ruptured intracranial aneurysms（OR=0.329,95%CI：0.144-0.735,P=0.021;OR=1.358,95%CI：2.531-5.622,P=0.002;OR=1.826,95%CI：1.521-2.103,P=0.019;OR=0.428,95%CI：0.246-0.745,P=0.003）.Conclusion Accurate comprehensive analysis,best operation time and right operation procedure play an important role in improving the outcomes in patients with ruptured intracranial aneurysms.

关 键 词：颅内动脉瘤 动脉瘤 破裂 年龄因素 预后 格拉斯哥预后评分 

分 类 号：R651.12[医药卫生—外科学]