影响颅内动脉瘤破裂夹闭手术预后的临床因素分析

发布时间：2018-06-04 23:43

  本文选题：颅内动脉瘤 + 夹闭手术　； 参考：《新乡医学院》2014年硕士论文

【摘要】：背景：患者在颅内动脉瘤破裂后非手术治疗一个月之内的死亡率高达50%以上,即便在存活的病人之中仍会遗留有严重的神经功能损害,对病人及家属都带来了非常大的危害。现阶段国内外研究颅内动脉瘤手术治疗预后影响因素主要包括年龄、基础疾病、术前Hunt-Hess分级、手术时机、动脉瘤特征、动脉瘤术中临时夹闭以及手术并发症等,但具体结果因样本差异均不一致,且部分因素还无定论。 目的：探讨瘤颈夹闭手术治疗颅内动脉瘤破裂预后的相关影响因素,以期为改善患者预后提供有力的参考依据。 方法：选择2010年2月～2013年2月在我院神经外科收治的248例颅内动脉瘤破裂病人作为本次研究对象,并符合纳入标准和排除标准。统计病人预后良好的例数,并对可能影响预后的年龄、性别、Hunt-hess分级、动脉瘤特征、手术时机以及高血压病史等因素进行单因素和多因素分析。 结果：(1)总共纳入的248例颅内动脉瘤患者中有199例(80.2%)预后良好,而有49例(19.8%)预后不良。(2)通过单因素分析,Hunt-hess分级、瘤颈宽度、动脉瘤部位、高血压等因素都对患者预后影响的差异显著,具有统计学意义(P0.05)；而年龄、性别、瘤体大小、多发动脉瘤、手术时机等因素都对患者预后影响的差异不显著,无统计学意义(P0.05)。 结论：(1)Hunt-hess分级(Ⅳ、V级)、瘤颈宽度(≥4mm)、动脉瘤部位(后循环动脉)、高血压等是颅内动脉瘤破裂预后的独立危险性因素。患者Hunt-hess分级高、瘤颈宽,动脉瘤处于后循环动脉,以及有高血压病史都使预后变差。(2)患者的年龄、性别、手术时机、动脉瘤大小及其是否多发等都与患者预后没有显著的相关性,不属于动脉瘤破裂预后的独立影响因素。
[Abstract]:Background: the death rate of patients with intracranial aneurysm rupture within one month after non-surgical treatment is as high as 50%, even in the survival of patients will still have serious neurological damage, which has brought great harm to patients and their families. At present, the factors influencing the prognosis of intracranial aneurysm surgery at home and abroad include age, underlying diseases, preoperative Hunt-Hess classification, surgical timing, aneurysm characteristics, temporary clipping during aneurysm operation and surgical complications. However, the specific results are not consistent because of sample differences, and some factors are not conclusive. Objective: to investigate the prognostic factors of intracranial aneurysm rupture in the treatment of intracranial aneurysm rupture by clipping operation of aneurysm neck, so as to provide a useful reference for improving the prognosis of patients. Methods: 248 patients with ruptured intracranial aneurysms from Feb 2010 to Feb 2013 in our hospital were selected as the subjects, and the criteria of inclusion and exclusion were met. The number of patients with good prognosis was counted, and univariate and multivariate analysis was carried out on factors such as age, sex Hunt-hess grade, characteristics of aneurysm, timing of operation and history of hypertension. Results among the 248 patients with intracranial aneurysm, 199 had good prognosis, while 49 had poor prognosis.) Hunt-hess grade, neck width and aneurysm location were analyzed by univariate analysis. However, age, sex, tumor size, multiple aneurysms, operative timing and other factors had no significant difference in the prognosis of the patients. Conclusion the Hunt-hess grade (鈪，

本文编号：1979380