血管内栓塞术治疗中小型颅内动脉瘤患者并发症发生情况及复发高危因素分析  

Complications Following Endovascular Embolization for Small and Medium-Sized Intracranial Aneurysms and Analysis of High-Risk Factors for Recurrence

作　　者：孙文强 张婕 王洪亮 SUN Wenqiang;ZHANG Jie;WANG Hongliang(Department of Neurology,Sixth People's Hospital of Nantong City,Nantong,Jiangsu 22601l,China)

机构地区：[1]江苏省南通市第六人民医院神经内科,江苏南通226011

出　　处：《转化医学杂志》2024年第10期1694-1697,1702,共5页Translational Medicine Journal

基　　金：南通市第六人民医院院级立项课题(ntly202202)。

摘　　要：目的探究血管内栓塞术治疗中小型颅内动脉瘤患者并发症发生情况及影响复发的高危因素。方法回顾性选取2020年1月至2022年12月南通市第六人民医院神经内科行血管内栓塞术治疗的中小型颅内动脉瘤患者87例临床资料。所有患者均接受6个月随访,统计术后并发症发生率;根据术后是否复发分为未复发组(n=74)和复发组(n=13),比较2组临床资料,并用多因素Logistic回归模型分析影响中小型动脉瘤血管内栓塞术术后复发的高危因素。结果87例患者中有12例出现并发症,并发症发生率13.79%。其中2例癫痫,3例脑积水,2例脑梗死,3例脑血管痉挛,2例颅内感染。单因素分析结果显示,复发组与未复发组年龄、合并糖尿病、合并高血压、Hunt-Hess分级、支架辅助、手术时机比较差异有统计学意义(P<0.05)。多因素分析显示,年龄≥60岁(OR=1.729,95%CI:1.245~2.447)、合并糖尿病(OR=2.147,95%CI:1.678~3.253)、合并高血压(OR=2.352,95%CI:1.740~3.411)、Hunt-Hess分级≥Ⅲ级(OR=1.953,95%CI:1.360~2.721)、无支架辅助(OR=1.785,95%CI:1.279~2.510)、手术时机≥24 h(OR=1.521,95%CI:1.190~1.938)是中小型动脉瘤血管内栓塞术术后复发的高危因素(P<0.05)。结论血管内栓塞术治疗中小型颅内动脉瘤并发症发生率低,但复发率较高,年龄、并发症、Hunt-Hess分级、支架辅助、手术时机是复发的影响因素。Objective To investigate the complications following endovascular embolization for small and medium-sized intracranial aneurysms and high-risk factors for recurrence.Methods The clinical data of 87 patients with small and medium-sized intracranial aneurysms who underwent endovascular embolization in the Neurology Department of Nantong Sixth People's Hospital from January 2020 to December 2022 were retrospectively analyzed.All patients were followed up for 6 months,and the incidence of postoperative complications was calculated.According to whether there was recurrence after surgery,the patients were divided into non-recurrence group(n=74)and recurrence group(n=13).The clinical data of the two groups were compared,and a multivariate Logistic regression model was used to analyze the high-risk factors affecting the recurrence after endovascular embolization for small and medium-sized aneurysms.Results Among the 87 patients,12 had complications,and the complication incidence rate was 13.79%.There were 2 cases of epilepsy,3 cases of hydrocephalus,2 cases of cerebral infarction,3 cases of cerebral vasospasm,and 2 cases of intracranial infection.Univariate analysis results showed that there were statistically significant differences in age,combined diabetes,combined hypertension,Hunt-Hess grade,stent assistance,and surgical timing between the recurrence group and the non-recurrence group(P<0.05).Multivariate analysis showed that age≥60 years old(OR=1.729,95%CI:1.245-2.447),combined diabetes(OR=2.147,95%CI:1.678-3.253),combined hypertension(OR=2.352,95%CI:1.740-3.411),Hunt-Hess grade≥III level(OR=1.953,95%CI:1.360-2.721),without stent assistance(OR=1.785,95%CI:1.279-2.510),and surgical timing≥24 h(OR=1.521,95%CI:1.190-1.938)were high-risk factors for recurrence after endovascular embolization for small and medium-sized aneurysms(P<0.05).Conclusion Endovascular embolization for small and medium-sized intracranial aneurysms has a low complication incidence rate but a relatively high recurrence rate.Age,complications,

关 键 词：栓塞 治疗性 颅内动脉瘤 并发症 复发 危险因素 

分 类 号：R651.122[医药卫生—外科学]