脑破裂动脉瘤术前再破裂的危险因素分析  

Risk factors for preoperative rerupture of cerebral ruptured aneurysms

作　　者：曹武阳 李晖 赵天浩 李征 CAO Wuyang;LI Hui;ZHAO Tianhao;LI Zheng(Department of Neurosurgery,Changde Hospital,Xiangya School of Medicine,Central South University(The First People’s Hospital of Changde City),Changde,Hunan 415003,China;Department of Neurosurgery,Xiangya Hospital of Central South University,Changsha,Hunan 410008,China;The First People’s Hospital of Pingjiang,Pingjiang,Hunan 410400,China)

机构地区：[1]中南大学湘雅医学院附属常德医院(常德市第一人民医院)神经外科,湖南常德415003 [2]中南大学湘雅医院神经外科,湖南长沙410008 [3]湖南省平江县第一人民医院,湖南平江410400

出　　处：《国际神经病学神经外科学杂志》2024年第4期36-40,共5页Journal of International Neurology and Neurosurgery

摘　　要：目的探讨并分析脑破裂动脉瘤在手术前再次破裂出血的危险因素。方法收集2018年1月—2021年12月中南大学湘雅医院收治的脑破裂动脉瘤的相关临床病例资料,使用Logistic多因素回归对数据进行统计分析。结果总共收集到526例脑破裂动脉瘤,男192例,女334例。手术前再次发生脑动脉瘤破裂出血患者有43例(8.17%),多因素回归分析发现,脑破裂动脉瘤瘤体有子瘤、入院后收缩压≥160 mmHg以及初次发病到入院时间大于6 h是脑破裂动脉瘤术前再次发生破裂出血的危险因素。结论对于脑破裂动脉瘤患者应尽早入院,且有子瘤和术前血压控制较差的患者应尽早采取治疗,可减少脑破裂动脉瘤术前再破裂出血的风险。Objective To investigate the risk factors for preoperative rerupture of cerebral ruptured aneurysms.Methods Clinical data were collected from the patients with ruptured cerebral aneurysms who were admitted to Xiangya Hospital of Central South University from January 2018 to December 2021,and the multivariate logistic regression method was used for statistical analysis.Results A total of 526 patients with ruptured cerebral aneurysms were enrolled,among whom there were 192 male patients and 334 female patients.Of all patients,43(8.17%)experienced rerupture of cerebral ruptured aneurysms before surgery,and the multivariate logistic regression analysis showed that ruptured cerebral aneurysms with sub-aneurysms,systolic pressure≥160 mmHg after admission,and a time of>6 hours from onset to admission were risk factors for rerupture of cerebral ruptured aneurysms before surgery.Conclusions Patients with ruptured cerebral aneurysms should be admitted as soon as possible,and patients with sub-aneurysms or poor blood pressure control before surgery should receive treatment as soon as possible to reduce the risk of preoperative rerupture of ruptured cerebral aneurysms.

关 键 词：动脉瘤 手术前 再次破裂 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]