颅内破裂动脉瘤血管内介入治疗时机的选择及其对病人预后的影响  

Timing of endovascular intervention for patients with ruptured intracranial aneurysm and its effect on patients’ prognoses

作　　者：黄德俊[1] 孙阳阳 万定[1] 冯进[1] 杨振兴[1] 李小龙 尹姬[3] HUANG De-jun;SUN Yang-yang;WAN Ding;FENG Jin;YANG Zhen-xing;LI Xiao-long;YU Ji(Department of Neurosurgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Graduate School of Ningxia Medical University,Yinchuan 750004,China;Department of Interventional Radiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院神经外科,银川750004 [2]宁夏医科大学研究生院,银川750004 [3]宁夏医科大学总医院介入放射科,银川750004

出　　处：《中国临床神经外科杂志》2022年第8期637-639,共3页Chinese Journal of Clinical Neurosurgery

基　　金：宁夏回族自治区科学技术厅重点研发项目(2018YBZD0034)。

摘　　要：目的探讨颅内破裂动脉瘤血管内介入治疗时机的选择及其对病人预后的影响。方法回顾性分析2018年1月至2020年6月血管内介入治疗的149例颅内破裂动脉瘤的临床资料。手术时机分为早期手术(≤72 h)和晚期手术(>72 h)。术后随访6个月,采用改良Rankin量表(mRS)评分评估预后,其中0~2分为预后良好,3~6分为预后不良。结果术后6个月,110例(73.8%)预后良好;39例(26.2%)预后不良,其中死亡12例。本文149例中,早期手术96例,晚期手术53例。早期手术预后良好率(82.3%,79/96)明显高于晚期手术(55.4%,31/56;P<0.05)。多因素logistic回归分析显示,晚期手术是颅内破裂动脉瘤预后不良的独立危险因素(P<0.05)。结论对于颅内破裂动脉瘤,早期手术可改善病人的预后。Objective To investigate the Timing of endovascular intervention for patients with ruptured intracranial aneurysm(RIA) and its effect on patients’ prognoses.Methods The clinical data of 149 patients with RIA who underwent endovascular embolization from January 2018 to June 2020 were analyzed retrospectively.The timing of embolization was classified as early embolization(≤72 h) and late embolization(>72 h).The patients were followed up for 6 months,and the patients’ prognoses were assessed by the modified Rankin Scale(mRS) score,with a mRS score of 0~2 as good prognosis and score of 3~6 as poor prognosis.Results Of 149 patients,110 patients(73.8%) had good prognoses and 39(26.2%) poor prognoses,including 12 deaths.Of these 149patients,96 patients received early embolization and 53 late embolization.The good prognosis rate of patients undergoing early surgery(82.3%,79/96) was significantly higher than that of patients undergoing late surgery(55.4%,31/56;P<0.05).Multivariate logistic regression analysis showed that late embolization was an independent risk factor for poor prognosis of patients with ruptured intracranial aneurysm(P<0.05).Conclusions Early endovascular embolization can improve the prognoses of patients with RIA.

关 键 词：颅内破裂动脉瘤 蛛网膜下腔出血 血管内治疗 预后 手术时机 

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]