颅内破裂动脉瘤血管内栓塞术后发生神经系统并发症的危险因素  

Analysis of factors related to neurological complications after interventional therapy in patients with ruptured intracranial aneurysms

作　　者：赵喜鹏[1] 张云峰[1] ZHAO Xi Peng;ZHANG Yun-feng(Department of Neurosurgery,Anqing Hospital,Navy,Chinese People's Liberation Army,Anqing 246000,China)

机构地区：[1]中国人民解放军海军安庆医院神经外科

出　　处：《中国临床神经外科杂志》2020年第1期19-21,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨颅内破裂动脉瘤血管内栓塞治疗后并发神经系统并发症的危险因素。方法回顾性分析2015年5月至2018年5月血管内栓塞治疗的190例颅内破裂动脉瘤的临床资料。采用多因素logistic回归分析检验危险因素。结果术后随访3个月,发生神经系统并发症21例,发生率为11.1%,其中其中血栓栓塞12例,术后早期再破裂出血4例,术中动脉瘤破裂3例,术后早期硬膜下出血或远隔部位脑实质出血2例。多因素logistic回归分析显示,合并高血压、Fisher分级Ⅲ~Ⅳ级、Hunt-Hess分级Ⅳ~Ⅴ级、宽颈动脉瘤、动脉瘤有小阜是颅内破裂动脉瘤血管内栓塞术后发生神经系统并发症发生的独立危险因素(P<0.05)。结论颅内破裂动脉瘤血管内栓塞术后神经系统并发症发生率较高,临床应对存在高危因素的病人提前做好术前预案,以减少术后并发症。Objective To investigate the risk factors of neurological complications after the interventional therapy of ruptured intracranial aneurysms(RIAs) and their prevention methods. Methods Of 190 patients with RIAs treated by interventional method in our hospital from May, 2015 to May, 2018, 21 suffered from postoperative neurological complications and 169 did not within 3 months after the interventional therapy. The Risk factors related to the neurological complications after intervention therapy of RIAs were analyzed.Results Twenty-one patients with postoperative neurological complications accounted for 11.05% 0 f the patients with RIAs receiving intentional therapy at the same period. Logistic regression analysis showed that hypertension history, Fisher grades Ⅲ~Ⅳ, Hunt-Hess grades Ⅳ~Ⅴ, wide-neck aneurysms, and caruncles were independent risk factors related to the neurological complications after the interventional therapy in the patients with RIAs(P<0.05). Conclusions There is a high rate of occurrence of neurological complications in the patients with RIAs after the interventional therapy. The present results suggest that the independent risk factors related to the postoperative neurological complications include the history of hypertension, Fisher grades Ⅲ-Ⅳ, Hunt-Hess grades Ⅳ~Ⅴ, wide-neck aneurysms and caruncles in the patients with RIAs.

关 键 词：颅内破裂动脉瘤 血管内栓塞 神经系统并发症 危险因素 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]