大脑后动脉瘤破裂危险多因素及其治疗结果分析  

Posterior Cerebral Artery Aneurysms rupture risk factor and treatment Outcome

作　　者：陈解南[1] 周新卫 彭冬红[1] 黄钟情 CHEN Jienan;ZHOU Xinwei;PENG Donghong;HUANG Zhongqing(Department of Medical Image Center,Zhuhai Maternal and Child Health,Zhuhai Guangdong,China,519000;Department of Medical Image Center,Yuebei People's Hospital,Shantou University Medical College,Shaoguan,Guangdong,China,512025)

机构地区：[1]珠海市妇幼保健院医学影像科,广东珠海519000 [2]汕头大学医学院附属粤北人民医院影像诊断科,广东韶关512025

出　　处：《分子诊断与治疗杂志》2020年第7期928-931,共4页Journal of Molecular Diagnostics and Therapy

基　　金：广东省医学科研项目(A2017043,A2018146);珠海市医疗卫生科技计划项目(20171009E030051);韶关市卫生计生科研项目(Y18092);韶关市科技局项目(2017 CX/010)。

摘　　要：目的探讨大脑后动脉瘤的破裂危险因素及其治疗疗效.方法选择2008年7月-2018年3月大脑动脉瘤患者87例作为对象.所有患者入院后均完成CTA和/或DSA检查,并在CTA和/或DSA上采集动脉瘤几何学参数,包括:瘤体宽度、瘤颈宽度、瘤体高度、载瘤动脉直径及动脉瘤形态.在电子病例库中回顾性采集患者高血压、脑血管病家族史等.采用多因素Logistic回归分析动脉瘤的破裂危险因素.依据大脑后动脉瘤是否破裂,将其分为破裂组和未破裂组以判断动脉瘤的破裂危险因素;依据大脑后动脉瘤的治疗方法,将其分为手术夹闭组和介入栓塞组,采用改良Rankin量表评分以评估患者治疗疗效.结果87例患者共发现121个动脉瘤,大脑后动脉瘤94个(伴发前循环动脉瘤17个,伴发椎-基底动脉瘤10个),破裂组35个动脉瘤,未破裂组59个动脉瘤.多因素Logistic分析结果表明:大脑后动脉瘤破裂与瘤体宽度、瘤颈宽度、瘤体高度及载瘤动脉直径无相关性(P>0.05);而大脑后动脉瘤的形态以及患者具有高血压、脑血管病家族史有关系,均为危险因素(P<0.05).87例患者中,30例给予手术夹闭,20(66.7%)例患者术后随访改良Rankin量表评分≤2;57例给予介入栓塞治疗,50(87.7%)例患者术后随访改良Rankin量表评分≤2(P>0.05).结论大脑后动脉瘤的形态以及患者具有高血压、脑血管病家族史是大脑后动脉瘤的破裂危险因素,手术夹闭或介入栓塞治疗大脑后动脉瘤患者能获得良好的预后.Objective To explore the risk factors of posterior cerebral aneurysm rupture and its therapeutic effect.Methods eighty seven patients with cerebral aneurysm from July 2008 to March 2018 were recruited.All patients underwent CTA and/or DSA examination after admission,and geometric parameters of aneurysm were collected on CTA and/or DSA,including tumor width,tumor neck width,tumor height,parent artery diameter and aneurysm shape.The family history of hypertension and cerebrovascular disease were collected in the electronic case bank.Multivariate logistic regression was used to analyze the risk factors of aneurysm rupture.According to whether the posterior cerebral aneurysm ruptured or not,it was divided into ruptured group and unruptured group to determine the risk factors of ruptured aneurysm;according to the treatment method of the posterior cerebral aneurysm,it was divided into surgical clipping group and interventional embolization group,and the treatment effect was evaluated by the modified Rankin scale.Results A total of 121 aneurysms were found in 87 patients,94 posterior cerebral aneurysms(17 with anterior circulation aneurysms and 10 with vertebral-basal aneurysms),35 aneurysms in the ruptured group and 59 aneurysms Aneurysm.The results of multivariate Logistic analysis showed that the rupture of the posterior cerebral aneurysm was not related to the width of the tumor,the width of the neck,the height of the tumor,and the diameter of the artery containing the tumor(P>0.05);Family history of cerebrovascular disease are risk factors,there is a correlation(P<0.05).Among 87 patients,30 were given surgical clips,20(66.7%)patients were followed up with modified Rankin scale score≤2;57 patients were given interventional embolization therapy,and 50(87.7%)patients were followed up with modified Rankin volume Table score≤2(P>0.05).Conclusion The shape of the posterior cerebral aneurysm and the family history of hypertension and cerebrovascular disease are the risk factors of the posterior cerebral aneurysm ruptu

关 键 词：大脑后动脉瘤 动脉瘤破裂 危险因素 影像学评估 治疗 

分 类 号：R743[医药卫生—神经病学与精神病学]