前循环破裂动脉瘤早期显微手术预后的相关因素分析

发布时间：2018-06-17 10:42

本文选题：前循环破裂动脉瘤 + 早期显微手术　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:分析前循环破裂动脉瘤早期显微手术的疗效,探讨影响前循环破裂动脉瘤患者早期显微手术预后的相关因素。方法:回顾性分析山西医科大学第一医院神经外科2014~2016年收治的89例早期显微手术治疗的前循环破裂动脉瘤患者病例资料,根据GOS评分评价患者预后,并利用SPSS19.0统计学软件对年龄、性别、高血压、糖尿病、术前Hunt-Hess分级、改良Fisher分级、术前再出血、动脉瘤大小、瘤颈宽度、术中动脉瘤破裂、临时阻断、迟发性脑缺血、肺部感染、颅内感染、术后脑脊液循环障碍及迟发出血等16项可能影响患者预后的相关因素进行分析,其中单因素分析采用c2检验,而多因素分析则采用Logistic回归分析。结果:早期显微手术治疗的89例前循环破裂动脉瘤患者中,58例预后良好(65.2%),31例预后不良(34.8%);单因素分析显示年龄、高血压、瘤颈宽度、术前Hunt-Hess分级、改良Fisher分级、迟发性脑缺血、肺部感染及术后脑脊液循环障碍与患者预后相关(P0.05);多因素Logistic回归分析显示术前Hunt-Hess分级(OR=8.994,P=0.048)、迟发性脑缺血(OR=7.586,P=0.027)及肺部感染(OR=8.323,P=0.004)是影响前循环破裂动脉瘤患者早期显微手术预后的危险因素。结论:早期显微手术是治疗前循环破裂动脉瘤的有效手段,术前Hunt-Hess分级、迟发性脑缺血及肺部感染是影响前循环破裂动脉瘤患者早期显微手术预后的危险因素。
[Abstract]:Objective: to analyze the effect of early microsurgery on ruptured anterior circulation aneurysms and to explore the factors influencing the prognosis of patients with ruptured anterior circulation aneurysms. Methods: the data of 89 patients with ruptured anterior circulatory aneurysms treated by early microsurgery from 2014-2016 in the first Hospital of Shanxi Medical University were retrospectively analyzed. The prognosis of the patients was evaluated according to the GOS score. Age, sex, hypertension, diabetes, preoperative Hunt-Hess grade, modified Fisher grade, preoperative rebleeding, aneurysm size, width of aneurysm, rupture of aneurysm during operation, temporary occlusion, delayed cerebral ischemia were analyzed by SPSS 19.0 software. Sixteen related factors, such as pulmonary infection, intracranial infection, cerebrospinal fluid circulation disorder and delayed hemorrhage, were analyzed. The univariate analysis was carried out by c2 test, and the multivariate analysis by Logistic regression analysis. Results: among 89 patients with ruptured anterior circulation aneurysm treated by early microsurgery, 58 cases had a good prognosis (65.2%) and 31 cases had poor prognosis (34.8%). Univariate analysis showed age, hypertension, neck width, Hunt-Hess grade before operation, modified Fisher grade, delayed cerebral ischemia. Multivariate logistic regression analysis showed that preoperative Hunt-Hess grade ORT 8.994 P0.048, delayed cerebral ischemia 7.586 P0.027) and pulmonary infection OR8.323P0.004 were associated with early microsurgery in patients with ruptured anterior circulatory aneurysms (P0.05), and multivariate logistic regression analysis (logistic regression analysis) showed that preoperative Hunt-Hess grade and delayed cerebral ischemia were associated with early microsurgery in patients with ruptured aneurysms of the anterior circulation. Risk factors for prognosis. Conclusion: early microsurgery is an effective method for the treatment of ruptured anterior circulation aneurysms. Preoperative Hunt-Hess grade, delayed cerebral ischemia and pulmonary infection are the risk factors for the prognosis of patients with ruptured anterior circulation aneurysms.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.12

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