脑动脉瘤栓塞术后脑血管痉挛分析  

Analysis of influencing factors for cerebral vasospasm after embolization of cerebral aneurysms

作　　者：张根堂 匡荣岩 陈焕磊 刘文涛 Zhang Gentang;Kuang Rongyan;Chen Huanlei;Liu Wentao(Department of Neurosurgery,Jiaozhou Central Hospital in Qingdao City,Shandong 266300,China)

机构地区：[1]青岛市胶州中心医院神经外科,山东266300

出　　处：《脑与神经疾病杂志》2025年第1期19-23,共5页Journal of Brain and Nervous Diseases

基　　金：2021年度青岛市医药卫生科研计划项目(2021-WJZD126)。

摘　　要：目的探讨脑动脉瘤栓塞术后脑血管痉挛(CVS)的诊断和影响因素分析。方法选取青岛市胶州中心医院神经外科的200例脑动脉瘤栓塞术后患者作为研究对象,通过Kaplan-Meier法和log-rank检验法评估生存曲线,评估指标包括性别、年龄、体质量、出血次数、手术时期、手术时间、高血压、糖尿病、饮酒史、吸烟史、Fisher分级。结果术后CVS并发的影响因素主要为手术时期、高血压、Fisher分级、年龄、出血次数、手术时间、吸烟史。其中200例脑动脉瘤栓塞术后患者,有55例并发CVS,发生率为27.5%;不同Fisher分级与吸烟史患者的术后CVS并发率差异有在统计学意义(χ^(2)=38.358,P<0.001),(χ^(2)=19.238,P<0.001)。不同饮酒史患者的术后CVS并发率差异无统计学意义(χ^(2)=0.419,P=0.517>0.05)。多因素Logistic回归分析显示,年龄≥55岁、手术时间>4h、Fisher分级3或4级、吸烟史、出血次数≥2次、中期手术及高血压是脑动脉瘤患者栓塞术后CVS发生的主要影响因素(P<0.05)。结论患者的手术时期、高血压、Fisher分级、年龄、出血次数、手术时间、吸烟史将会影响术后CVS并发的概率,进而也会对患者的术后康复和护理造成影响。Objective Exploring the diagnosis and influencing factors analysis of cerebral vasospasm complications in 200 cases of cerebral aneurysms after embolization.Methods 200 patients with(CVS)after embolization in the Department of Neurosurgery of Qingdao Jiaozhou Central Hospital were selected as the study subjects.The survival curve was evaluated by Kaplan Meier method and log rank test.The evaluation indicators included gender,age,body mass index(BMI),bleeding times,operation period,operation time,hypertension,diabetes,drinking history,smoking history,Fisher classification.Results The main influencing factors for postoperative CVS complications are surgical period,hypertension,Fisher grading,age,number of bleeding episodes,surgical time,and smoking history.Among the 200 patients who underwent embolization of(CVS),55 had concurrent CVS,with an incidence rate of 27.5%;The incidence of postoperative CVS in patients with different Fisher grades and smoking history was statistically significant(χ^(2)=38.358,P<0.001),(χ^(2)=19.238,P<0.001).The incidence of postoperative CVS in patients with different alcohol consumption histories was not statistically significant(χ^(2)=0.419,P=0.517>0.05).Multivariate Logistic regression analysis showed that age≥55 years,surgery time>4 hours,Fisher grade 3 or 4,smoking history,bleeding frequency≥2 times,mid-term surgery,and hypertension were the main factors influencing the occurrence of CVS in post-embolisation aneurysm patients(P<0.05).Conclusion The surgical period,hypertension,Fisher classification,age,number of bleeding episodes,surgical time,and smoking history of patients will affect the probability of postoperative CVS complications,which will also have an impact on the patient's postoperative recovery and care.

关 键 词：回归分析 脑动脉瘤栓塞 脑血管痉挛 术后 

分 类 号：R651.1[医药卫生—外科学]