颅内破裂微小动脉瘤介入治疗预后的危险因素分析

目的 探讨颅内破裂微小动脉瘤介入治疗预后的危险因素。方法 回顾性分析2012年2月1日至2016年2月1日介入治疗的52例颅内破裂微小动脉瘤的临床资料。出院后6个月采用改良Rankin量表评分判定预后，0~2分预后良好，3~6分预后不良。采用多因素Logistic回归分析检验预后危险因素。结果 43例采用单纯弹簧圈栓塞，9例采用支架辅助弹簧圈栓塞；完全栓塞26例，近完全栓塞26例。术后发生明显并发症（脑血管痉挛、肺部感染、颅内感染）共16例。40例预后良好，12例预后不良。多因素Logistic回归分析显示术前Hunt-Hess分级高、术前Fisher评分高、术后发生并发症是颅内破裂微小动脉瘤介入治疗不良预后的独立危险因素（P<0.05）。结论 介入治疗颅内破裂微小动脉瘤可取得良好效果；术前要根据病人Hess-Hess分级、Fisher分级评估病情，制定个性化治疗方案，预防和减轻并发症，从而提高介入治疗的效果。

Analysis of risk factors related to prognoses in patients with intracranial ruptured tiny aneurysms treated by interventional therapy

Objective To investigate the risk factors related to prognoses in the patients with ruptured intracranial tiny aneurysms treated by interventional therapy. Methods The clinical data of 52 patients with ruptured tiny cerebral aneurysms, who were treated by interventional therapy from February, 2012 to February, 2016, were analyzed retrospectively. The therapeutic outcomes were assessed by modified Rankin scale 6 months after the discharge from hospital. The factors related to the prognoses including Hunt-Hess grade on admission, whether the patients received anti-epileptic treatment, whether there is obvious complication, etc were analyzed by univariate and multivariate logistic regression analysis. Results Of 52 patients, 40 (77%) had good prognoses and 12 (23%) poor prognoses. The univariate analysis showed that the factors related to the prognosis included Hunt-Hess grade, Fisher grade, and obvious complications in the patients with ruptured intracranial tiny aneurysms treated by interventional therapy (P<0.05). Multivariate analysis showed that the independent risk factors related to the prognoses included high Hunt-Hess grade (grades Ⅲ~Ⅳ), high Fisher grade (grade 4) and obvious complications in the patients with ruptured intracranial tiny aneurysms treated by interventional therapy (P<0.05). Conclusion The high Hunt-Hess grade, higher Fisher grade and obvious complications are related to poor prognosis in the patients with ruptured intracranial tiny aneurysms treated by interventional therapy. Attachment of importance to the above-mentioned factors may be helpful to improving the prognoses in the patients with ruptured intracranial tiny aneurysms treated by interventional therapy.