血管内治疗老年未破裂动脉瘤的预后分析  

Prognosis of endovascular treatment for unruptured intracranial aneurysms in elderly patients

作　　者：赵玉龙 白杨 陈立刚 熊剑 梁国标 高旭 ZHAO Yulong;BAI Yang;CHEN Ligang;XIONG Jian;LIANG Guobiao;GAO Xu(Department of Neurosurgery,General Hospital of the Northern Theater Command of the Chinese People's Liberation Army,PLA Institute of Neuromedicine,Shenyang,Liaoning 110016,China)

机构地区：[1]中国人民解放军北部战区总医院神经外科,全军神经医学研究所,辽宁沈阳110016

出　　处：《中华神经外科疾病研究杂志》2024年第6期38-41,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：辽宁省重点研发计划(2019010207-JH8/103);辽宁省“兴辽人才计划”(XLYC2002109)。

摘　　要：目的探讨血管内治疗老年未破裂动脉瘤的预后情况及相关危险因素。方法回顾性分析2013年1月至2020年12月在中国人民解放军北部战区总医院神经外科行颅内动脉瘤栓塞术的老年未破裂动脉瘤患者的临床资料,分析其危险因素。结果623例患者中有57例(9.15%)发生围术期并发症。单因素分析结果显示性别(P=0.006)、高血压(P<0.001)、冠心病(P<0.001)、合并其他颅内血管重度狭窄(P<0.001)、既往TIA发作(P=0.007)、陈旧性脑梗死病史(P=0.004)、肾功能不全(P=0.021)、多发动脉瘤(P<0.001)、动脉瘤形态不规则或有子瘤(P<0.001)与围术期并发症的发生有关;多因素分析结果显示既往TIA发作、冠心病及动脉瘤形态不规则或有子瘤是围术期并发症发生的独立危险因素。结论既往TIA发作、冠心病及动脉瘤形态不规则或有子瘤是血管内治疗老年未破裂颅内动脉瘤术后预后不良的独立危险因素。Objective To explore the prognosis and related risk factors of endovascular treatment for unruptured aneurysms in elderly patients.Methods The clinical data of 623 elderly patients with unruptured intracranial aneurysms(UIAs)who underwent embolization of intracranial aneurysms in the Department of Neurosurgery of the General Hospital of the Northern Theater Command of the Chinese People's Liberation Army from January 2013 to December 2020 were retrospectively analyzed,with a focus on the risk factors.Results Out of the 623 patients,57(9.15%)experienced perioperative complications.Results of univariate analysis showed that gender(P=0.006),hypertension(P<0.001),coronary heart disease(P<0.001),severe stenosis of other intracranial vessels(P<0.001),previous TIA attacks(P=0.007),history of old cerebral infarction(P=0.004),renal dysfunction(P=0.021),multiple aneurysms(P<0.001),irregular aneurysm morphology or sub aneurysms(P<0.001)were associated with the occurrence of perioperative complications.Results of multivariate analysis showed that previous TIA attacks,coronary heart disease,and irregular or sub tumor morphology of aneurysms were independent risk factors for perioperative complications.Conclusions Previous TIA attacks,coronary heart disease,and irregular or sub aneurysm morphology are independent risk factors for poor prognosis after endovascular treatment for unruptured intracranial aneurysms in elderly patients.

关 键 词：老年患者 未破裂颅内动脉瘤 血管内治疗 预后 

分 类 号：R732.21[医药卫生—肿瘤]