直径<5 mm颅内动脉瘤破裂预后不良危险因素分析  

作　　者：郝以姝 周天梅[1] 

机构地区：[1]浙江中医药大学附属杭州市中医院,310000

出　　处：《浙江临床医学》2021年第11期1628-1630,共3页Zhejiang Clinical Medical Journal

摘　　要：目的分析直径<5 mm颅内动脉瘤破裂的危险因素,探讨小直径动脉瘤破裂致蛛网膜下腔出血患者预后不良的影响因素方法回顾性分析2018年1月至2020年1月直径<5 mm的27例未破裂和75例破裂颅内动脉瘤患者临床资料,分析动脉瘤破裂的危险因素。对75例破裂组患者随访,恨据出院后28d的GOS评分将其分为预后良好组(Ⅳ〜Ⅴ级)和预后不良组(I〜Ⅲ级),比较两组资料,探讨预后不良的影响因素:结果单因素分析显示,未破裂组和破裂组在有无糖尿病、动脉瘤部位及形态方面差异有统计学意义(P<0.05)而破裂颅内动脉瘤中,预后良好组和预后不良组在Hunt-Hess分级方面差异有统计学意义(P<0.05)结论不规则形态动脉瘤及动脉瘤部位是破裂的危险因素,Hunt-Hess分级≥4级是动脉瘤破裂后蛛网膜下腔出血患者预后不良的危险因素。Objective To analyze risk factors of rupture of intracranial aneurysms with a diameter<5 mm and prognostic factors of unfavorable outcome of aneurysmal subarachnoid hemorrhage.Methods From January 2018 to January 2020,27 unniptiired and 75 ruptured cases of intracranial aneurysms<5 mm admitted to Hangzhou Hospital of Traditional Chinese Medicine were retrospectively included.Rup-tiired risk factors of intracranial aneurysms were analyzed on basis of clinical data of two groups.Folio-w up was performed 28 d after discharge by recording Glasgow Outcome Scale(GOS)in ruptured grou-p,within which I〜Ⅲ as unfavorable outcome and Ⅳ〜Ⅴ as favorable Outcome.Prognostic factors of unfav-orable outcome were investigated by comparing clinical data of both groups.Results The univariate analysis showed that the difTerences between the ruptured group«md the unmptured group were stadsticaUy significant in terms of Diabetes,aneurysm location and shape(P<0.05).Within ruptured group,difference between the favorable prognosis group and the unfavorable prognosis group was statistically significant in temis of Hunt-Hess classification(P<0.05).Conclusion Irregular shaped aneurysms and aneurysm location are risk factors of mpture of intracranial aneurysms.In addition,Hunt-Hess grade≥Grade Ⅳ is a factor increasing the risk of unfavorable outcome in aneurysmal subarachnoid hemorrhage patients.

关 键 词：颅内小动脉瘤 破裂 危险因素 预后不良 回顾性分析 

分 类 号：R65[医药卫生—外科学]