颅内动脉瘤夹闭术后发生脑血管痉挛的危险因素与预防措施研究  

Study on risk factors and preventive measures for cerebral vasospasm after clipping of intracranial aneurysm

作　　者：程宇宏[1] 王浩[1] 张海涛[1] 

机构地区：[1]山西省临汾市第四人民医院神经外科,山西临汾041000

出　　处：《临床和实验医学杂志》2017年第3期288-290,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的总结颅内动脉瘤夹闭术后发生脑血管痉挛的危险因素及预防脑血管痉挛的措施。方法将2010年8月至2016年5月期间所收治颅内动脉瘤患者作为研究对象,共110例。所有患者均经全脑血管造影检查确诊,采用颅内动脉瘤夹闭术治疗。对患者临床资料进行回顾性分析,统计发生脑血管痉挛的20例患者相关临床资料,根据年龄、性别、蛛网膜下腔出血次数、以及Fisher分级作为分组标准,计算不同组别脑血管痉挛的发生率差异。结果年龄≤50岁、蛛网膜下腔出血>2次、Fisher分级>Ⅱ级患者脑血管痉挛发生率分别为80.00%(16/20)、75.00%(15/20)、65.00%(13/20),均显著高于其他组别,差异有统计学意义(P<0.05)。年龄≤50岁、蛛网膜下腔出血>2次、Fisher分级>Ⅱ级与颅内动脉瘤夹闭术后发生脑血管痉挛有相关性(P<0.05)。结论年龄≤50岁、蛛网膜下腔出血>2次、Fisher分级>Ⅱ级患者均为颅内动脉瘤夹闭术后脑血管痉挛事件发生的高危因素,需术前对患者风险程度、术后并发症危险性进行准确评估,加强围术期全面监测与护理,以达到预防脑血管痉挛事件发生的目的。Objective To summarize the risk factors for cerebral vasospasm after clipping of intracranial aneurysm and the measures for prevention of cerebral vasospasm.Methods A total of 110 patients with intracranial aneurysm were treated in this hospital during August 2010 to May 2016.All these patients were diagnosed by cerebral angiography,and all of them were treated with clipping of intracranial aneurysms.The clinical data of these patients were retrospectively ansalyzed.The clinical data of 20 patients with occurrence of cerebral vascular spasm were divid-ed into different groups according to their age,gender,times of subarachnoid bleeding and Fisher grades as grouping criteria to calculate the difference in incidence of cerebral vascular spasm in different groups.Results The incidence rates of cerebral spasm in patients with age less than or equal to 50 years old,subarachnoid hemorrhage（ SAH） 2 times,Fisher grade II level were 80.00%（ 16 /20）,75%（ 15 /20） and 65.00%（ 13 /20） respectively,and their difference was significantly higher than that of other groups（ P〈0.05）,and the difference was statistically significant.Patients with age less than or equal to 50 years old,subarachnoid hemorrhage 2 times,and Fisher grade class II were risk factors of cerebral vascular spasm after clipping of intracranial aneurysm and their correlation had statistical significance（ P〈0.05）.Conclusion Patients with age less than or equal to 50 years old,SAH 2 times,Fisher grade class II are high risk factors for occurrence of postoperative cerebral vasospasm events after clipping of intracranial aneurysm,by means of risk degree in preoperative patients,accurate assessment of risk of postoperative complications and strengthen comprehensive perioperative monitoring and nursing in order to prevent the occurrence of cerebral vescular spasm.

关 键 词：颅内动脉瘤 夹闭术 脑血管痉挛 危险因素 

分 类 号：R651.12[医药卫生—外科学]