破裂前交通动脉瘤术后患者认知功能及预后的临床研究  

Clinical study on cognitive function and prognosis of patients with ruptured anterior communicating artery aneurysm after operation

作　　者：王士洲 徐新娟 王策 王科科[1] 黄忻涛[1] 马宁[1] 刘爱华[2] Wang Shizhou;Xu Xinjuan;Wang Ce;Wang Keke;Huang Xintao;Ma Ning;Liu Aihua(Department of Neurosurgery,The First Hospital of Shanxi Medical University,Taiyuan 030000,China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]山西医科大学第一医院神经外科,太原030000 [2]首都医科大学附属北京天坛医院神经外科,北京100050

出　　处：《中华神经创伤外科电子杂志》2020年第5期259-264,共6页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：山西省卫生和计划生育委员会研究基金(2015023);山西青年科学家自然科学基金(201601D202097);山西省高等学校教育科技创新项目(2018020064);重点研究和开发项目(201803D31112);山西医科大学第一医院研究基金(YB161709);十二五国家科技支撑计划合作课题(2011BA108B06)。

摘　　要：目的研究破裂前交通动脉瘤手术治疗后患者的认知功能及预后情况。方法回顾性分析山西医科大学第一医院神经外科自2015年3月至2017年6月连续收治的94例破裂前交通动脉瘤患者的临床资料,应用认知功能电话问卷修订版及工具性日常生活能力量表、改良Rankin量表评价术后患者的认知功能及预后。采用单因素分析及多因素Logistic回归分析术后患者认知功能与预后的影响因素。结果67例患者完成了术后认知功能及预后的随访评价。单因素分析:Hunt-Hess分级、文化程度是术后患者认知功能的影响因素(P<0.05);Hunt-Hess分级、Fisher分级、年龄、文化程度是患者预后的影响因素(P<0.05)。进一步行多因素分析,高文化程度是术后患者认知功能的独立影响因素(OR=0.073,95%CI:0.008~0.638,P=0.018)。结论高文化程度是术后患者认知功能的独立影响因素,且是保护因素。Objective To investigate the cognitive function and prognosis of patients with ruptured anterior communicating aneurysm after surgical treatment.Methods Retrospective analysis was made on the clinical data of 94 consecutive patients with ruptured anterior communicating aneurysm admitted to Neurosurgery Department of The First Hospital of Shanxi Medical University from March 2015 to June 2017.The cognitive function and prognosis of postoperative patients were evaluated by means of telephone interview for cognitive status-modified,instrumental daily living ability scale and modified Rankin scale.Univariate analysis and multifactorial Logistic regression analysis were used to analyze the influencing factors of postoperative patients’cognitive function and prognosis.Results Follow-up evaluation of postoperative cognitive function and prognosis was completed in 67 patients.Univariate analysis:Hunt-Hess grade and degree of education were influential factors for postoperative cognitive function in patients(P<0.05).Hunt-Hess grade,Fisher grade,age and degree of education were influential factors for prognosis of the patients(P<0.05).Further multi-factor Logistic analysis showed that high education level was an independent factor affecting postoperative cognitive function of patients(OR=0.073,95%CI:0.008-0.638,P=0.018).Conclusion High educational level is an independent and protective factor of postoperative cognitive function.

关 键 词：颅内动脉瘤 开颅手术 介入治疗 认知障碍 

分 类 号：R651.12[医药卫生—外科学]