颅内后交通动脉瘤破裂出血的临床特征和形态学的危险因素  

Clinical Features and Morphological Risk Factors of Ruptured and Hemorrhage of Posterior Communicating Artery Aneurysm

作　　者：刘涛[1,2] 朱晓锋 马俊 李世鹏[1] 耿鑫[1] 李经辉[1] 余化霖[1] 白鹏[1] LIU Tao;ZHU Xiao-feng;MA Jun;LI Shi-peng;GENG Xin;LI Jing-hui;YU Hua-lin;BAI Peng(Dept.of Neurosurgery,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032;Dept.of Neurosurgery,Shenzhen Qianhai Taikang International Hospital,Shenzhen Guangdong 518000,China)

机构地区：[1]昆明医科大学第一附属医院神经外二科,云南昆明650032 [2]深圳前海泰康国际医院神经外科,广东深圳518000

出　　处：《昆明医科大学学报》2021年第12期67-73,共7页Journal of Kunming Medical University

基　　金：云南省高层次卫生计生技术人才培养-云南省卫生健康委员会医学后备人才培养计划基金资助项目(H-2018054);云南省神经系统疾病诊疗中心应用基础研究专项基金资助项目(ZX2019-03-05);昆明医科大学第一附属医院博士科研基金资助项目(2020BS019)。

摘　　要：目的分析颅内后交通动脉瘤破裂出血的临床特征和形态学危险因素,以期为后交通动脉瘤的临床诊治提供决策依据。方法对昆明医科大学第一附属医院神经外二科2016年1月至2020年12月诊断为后交通动脉瘤的72例患者的临床资料进行回顾性分析。统计患者的临床资料和动脉瘤形态学参数,根据是否并发蛛网膜下腔出血分为破裂组和未破裂组,使用SPSS软件进行统计学分析,分析与后交通动脉瘤破裂有关的危险因素。结果2组患者在基础特征如性别、年龄、吸烟史的比较,差异无统计学意义(P>0.05),而在高血压、动脉瘤的最大直径小于5 mm、入射角>90°、子囊和泡样突起、形态是否规则的、瘤顶朝向的比较,差异有统计学意义(P<0.05)。多因素分析表明,高血压(OR:5.82,95%CI:1.23~27.51)、射角大于90°(OR:7.88,95%CI:1.27~48.59)、子囊和泡样突起(OR:11.92,95%CI:2.06~68.76)是后交通动脉瘤破裂的独立危险因素。结论高血压史、最大直径小于5 mm、入射角大于90°、子囊和动脉瘤泡样突起、瘤顶朝向后外下方是后交通动脉瘤破裂的危险因素裂。Objective To analyze the clinical features and morphological risk factors of rupture and hemorrhage of posterior communicating artery aneurysm in the brain,in order to provide decision-making basis for the clinical diagnosis and treatment of posterior communicating artery aneurysm.Methods The clinical data of 72 patients diagnosed with posterior communicating aneurysm from January 2016 to December 2020 in the Second Department of Neurosurgery,First Affiliated Hospital of Kunming Medical University were retrospectively analyzed.The clinical data and aneurysm morphological parameters of the patients were collected.According to whether subarachnoid hemorrhage was complicated,they were divided into ruptured group and unruptured group.SPSS software was used for statistical analysis to analyze the risk factors related to the rupture of posterior communicating aneurysm.Results There was no statistically significant difference(P>0.05)between the two groups in the comparison of basic characteristics such as gender,age,and smoking history,while there was a statistically significant difference(P<0.05)in the comparison of hypertension,maximum diameter of the aneurysm less than 5 mm,Inflow angle more than 90°,daughter sacs and bleb,whether the morphology was regular or not,and the orientation of the apex of the aneurysm.Multifactorial analysis showed that hypertension(OR:5.82,95%CI:1.23-27.51),Inflow angle>90°(OR:7.88,95%CI:1.27-48.59),and daughter sacs and bleb(OR:11.92,95%CI:2.06-68.76)were independent risk factors for posterior communicating aneurysm rupture.Conclusion A history of hypertension,a maximum diameter smaller than 5 mm,an Inflow angle greater than 90°,daughter sacs and bleb,dome of the aneurysm directed to posterior-outer-inferior were risk factors for posterior communicating aneurysm rupture.Conclusion A history of hypertension,a maximum diameter smaller than 5 mm,an Inflow angle greater than 90°,daughter sacs and bleb,dome of the aneurysm directed to posterior-outer-inferior were risk factors for posterio

关 键 词：颅内动脉瘤 后交通动脉瘤 破裂危险因素 形态学 

分 类 号：R651.1[医药卫生—外科学]