颅内动脉瘤患者介入术后并发脑血管痉挛的危险因素分析  

Risk factors for cerebral vasospasm after intervention in patients with intracranial aneurysms

作　　者：李小换[1] 许佳贝 常文爱 Li Xiaohuan;Xu Jiabei;Chang Wen’ai(Department of Neurosurgery,Jiaozuo People’s Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作市人民医院神经外科,焦作454000

出　　处：《中国实用医刊》2023年第15期51-54,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析颅内动脉瘤患者介入术后并发脑血管痉挛的危险因素。方法抽取2021年7月至2022年12月于焦作市人民医院接受治疗的135例颅内动脉瘤患者作为研究对象,所有患者均接受介入术治疗,收集整理患者的临床资料,统计135例患者术后脑血管痉挛的发生情况,并根据是否发生脑血管痉挛分为痉挛组和非痉挛组。采用单因素、多因素Logistic回归分析法分析导致颅内动脉瘤患者介入术后发生脑血管痉挛的危险因素。结果135例患者中介入术后发生脑血管痉挛55例,发生率为40.74%,纳入痉挛组;其余未出现脑血管痉挛的80例患者纳入非痉挛组。经单因素分析发现,痉挛组和非痉挛组患者年龄(t=7.44)、吸烟史(χ^(2)=4.84)、Fisher分级(χ^(2)=10.74)、动脉瘤长径(t=4.98)、动脉瘤破裂(χ^(2)=10.37)、Hunt-Hess分级(χ^(2)=10.37)、手术时机(t=4.17)、全血白细胞计数(χ^(2)=13.16)、血糖水平(χ^(2)=6.63)比较差异均有统计学意义(P均<0.05)。多因素Logistic回归分析结果显示,年龄≥60岁(OR=2.599)、Fisher分级>Ⅱ级(OR=1.941)、动脉瘤长径≥1 cm(OR=2.077)、Hunt-Hess分级>Ⅱ级(OR=1.914)、全血白细胞计数≥15×109/L(OR=1.679)、血糖≥7 mmol/L(OR=2.373)是导致颅内动脉瘤患者介入术后发生脑血管痉挛的危险因素(P<0.05)。结论导致颅内动脉瘤患者介入术后发生脑血管痉挛的危险因素有年龄≥60岁、Fisher分级>Ⅱ级、动脉瘤长径≥1 cm、Hunt-Hess分级>Ⅱ级、全血白细胞计数≥15×10^(9)/L、血糖≥7 mmol/L。Objective To analyze the risk factors for cerebral vasospasm after interventional surgery in patients with intracranial aneurysm.Methods A total of 135 patients with intracranial aneurysms who were treated in Jiaozuo People’s Hospital from July 2021 to December 2022 were selected as research subjects,and all patients were treated by interventional surgery.The clinical data of the patients were collected and analyzed,and the incidence of postoperative cerebral vasospasm in the 135 patients was statistically analyzed.According to occurrence of cerebral vasospasm,the selected patients were divided into spasm group and non-spasm group.The risk factors leading to cerebral vasospasm in patients with intracranial aneurysms after interventional surgery were analyzed by univariate and multi-variate logistic regression methods.Results Among the 135 patients,55 cases developed cerebral vasospasm after interventional surgery,with an incidence of 40.74%,and they were included in the spasm group;the remaining 80 patients who did not experience cerebral vasospasm were included in the non-spasm group.Results of univariate analysis showed that there were significant differences in age(t=7.44),smoking history(χ^(2)=4.84),Fisher classification(χ^(2)=10.74),major diameter of aneurysm(t=4.98),aneurysm rupture(χ^(2)=10.37),Hunt-Hess classification(χ^(2)=10.37),timing of surgery(t=4.17),whole blood white blood cell count(χ^(2)=13.16),and blood glucose level(χ^(2)=6.63)between the spasm group and non-spasm group(all P<0.05).The results of multivariate logistic regression analysis showed that age≥60 years(OR=2.599),Fisher classification>gradeⅡ(OR=1.941),major diameter of aneurysm≥1 cm(OR=2.077),Hunt-Hess classification>gradeⅡ(OR=1.914),and whole blood white blood cell count≥15×109/L(OR=1.679)and blood glucose≥7 mmol/L(OR=2.373)were risk factors for cerebral vasospasm in patients with intracranial aneurysms after interventional surgery(P<0.05).Conclusions The risk factors for cerebral vasospasm in patients with intrac

关 键 词：颅内动脉瘤 介入术 脑血管痉挛 危险因素 

分 类 号：R651.12[医药卫生—外科学]