已破裂前循环动脉瘤外科手术夹闭治疗预后的相关因素分析

发布时间：2018-11-04 11:29

【摘要】：目的:探讨已破裂前循环动脉瘤外科手术夹闭治疗预后的相关因素。资料与方法:回顾性分析61例经外科手术夹闭治疗的已破裂前循环动脉瘤患者的病历资料,包括患者的年龄、出血次数、Hunt-Hess评分、Fisher评分等。患者出院后6个月的预后情况采用改良的Rankin量表评分(mRS)作为评分标准。先对可能影响预后的因素进行单因素分析,再将单因素分析有统计学意义的因素纳入多因素Logistic回归进行分析。结果:单因素分析提示出血次数、Hunt-Hess评分、GCS评分、Fisher评分、术后有无脑血管并发症、术后有无颅内感染与预后相关(P0.05),多因素分析提示Hunt-Hess评分(OR=40.243)、Fisher评分(OR=12.820)、术后脑血管并发症(OR=39.469)是影响已破裂前循环动脉瘤预后的独立危险因素(P0.05)。结论:Hunt-Hess评分、Fisher评分、术后有无脑血管并发症是显著影响已破裂前循环动脉瘤外科手术夹闭治疗患者预后的因素,重视这些因素的预测价值对降低已破裂前循环动脉瘤患者的病死率和致残率有重要临床意义。
[Abstract]:Objective: to investigate the prognostic factors of ruptured anterior circulatory aneurysms after surgical clipping. Materials and methods: the medical records of 61 patients with ruptured anterior circulatory aneurysms, including age, bleeding times, Hunt-Hess score, Fisher score and so on, were analyzed retrospectively. The prognosis of the patients at 6 months after discharge was evaluated by modified Rankin scale score (mRS). The factors that may affect the prognosis were analyzed by univariate analysis, and then the factors with statistical significance were analyzed by multivariate Logistic regression analysis. Results: univariate analysis showed that bleeding frequency, Hunt-Hess score, GCS score, Fisher score, postoperative cerebrovascular complications, postoperative intracranial infection and prognosis were related to the prognosis (P0.05), multivariate analysis suggested Hunt-Hess score (OR=40.243). Fisher score (OR=12.820) and postoperative cerebrovascular complications (OR=39.469) were independent risk factors for prognosis of ruptured anterior circulatory aneurysms (P0.05). Conclusion: Hunt-Hess score, Fisher score, postoperative cerebrovascular complications are the significant factors that affect the prognosis of patients with ruptured anterior circulation aneurysm after surgical clipping. Paying attention to the predictive value of these factors is of great clinical significance in reducing the mortality and disability rate of patients with ruptured anterior circulatory aneurysms.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.12

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