手术夹闭合并同侧胚胎型大脑后动脉的后交通动脉瘤预后因素分析

目的探讨手术夹闭存在胚胎型大脑后动脉的后交通动脉瘤(PCoAA)预后的影响因素。方法选择徐州医科大学附属医院神经外科2015年1月至2019年1月经显微手术夹闭合并胚胎型大脑后动脉的PCoAA患者80例,术后6个月采用改良Rankin量表评价患者预后,采用单因素分析和多因素Logistic回归分析影响患者预后的因素。结果性别、动脉瘤侧别、宽颈、动脉瘤大小、脑梗死史、手术时机、高血压史对手术预后影响不大;而年龄、Hunt-Hess分级、改良Fisher分级是影响手术预后的危险因素。结论年龄、术前Hunt-Hess分级以及改良Fisher分级是患者预后不良的独立影响因素;对于年龄不大、Hunt-Hess低分级、改良Fisher低分级这类患者,更早进行显微外科手术治疗,安全性更高,预后更好。

Influence factors of surgical clipping on prognosis of patients with fetal-type posterior cerebral artery and posterior communicating artery aneurysms

Objective To investigate the influence factors of surgical clipping on the prognosis of patients with posterior communicating artery aneurysms of fetal-type posterior cerebral artery.Methods A total of 80 patients with posterior communicating artery aneurysms of fetal-type posterior cerebral artery clipped by microsurgery in the neurosurgery department of affiliated hospital of Xuzhou medical university from January 2015 to January 2019 were retrospectively included.The prognosis was evaluated by modified Rankin score at 6 months after operation,and the influence factors were analyzed by univariate analysis and multivariate logistic regression analysis.Results Gender,aneurysm side,wide neck,aneurysm size,history of cerebral infarction,operation time and history of hypertension had little effect on the curative effect of surgery,while the age,Hunt-Hess grade and modified Fisher grade were the risk factors affecting the curative effect of surgery.Conclusion It is found that the age,Hunt-Hess grade and modified Fisher grade were the independent influence factors of poor prognosis.For young patients or patients with Hunt-Hess grade and modified Fisher grade of aneurysm,the early surgery need to be performed,which is safer and may achieve a better prognosis.