颅内破裂动脉瘤术前再破裂的危险因素

目的探讨颅内破裂动脉瘤术前再次破裂出血的危险因素。方法回顾性分析2017年1月1日至2020年12月31日收治的873例颅内破裂动脉瘤的临床资料。采用多因素logistic回归分析方法分析术前再次破裂的危险因素。结果 873例中,术前动脉瘤再次破裂出血72例(8.25%),术前未破裂出血801例(91.75%)。多因素logistic回归分析结果显示:发病到入院时间>6 h(OR=7.338;95%CI 4.356～13.320;P<0.001)、动脉瘤最大径>10 mm(OR=2.476;95%CI 1.211～5.060;P=0.013)、入院收缩压≥160 mmHg(OR=3.058;95%CI 1.781～5.249;P<0.001)是颅内破裂动脉瘤术前再次破裂的独立危险因素。结论对于颅内破裂动脉瘤病人,如果发病至入院时间长、动脉瘤较大、术前血压控制不理想,应尽早治疗动脉瘤,可减少再破裂率。

Risk factors related to preoperative rebleeding in patients with ruptured intracranial aneurysm

Objective To investigate the risk factors related to preoperative rebleeding in the patients with ruptured intracranial aneurysm (RIA). Methods The clinical data of 873 patients with RIA who were treated in our hospital from January 1st, 2017 to December 31st, 2020 were retrospectively analyzed. The risk factors related to preoperative rebleeding were analyzed using multivariate logistic regression analysis. Results Of 873 patients, 72 (8.25% ) patients suffered from rebleeding and 801 (91.75% ) did not. Multivariate logistic regression analysis showed that the time from onset to admission >6 h (OR=7.338; 95%CI 4.356~13.320; P<0.001) and the maximum diameter of aneurysm >10 mm (OR=2.476; 95%CI 1.211~5.060; P=0.013) and systolic blood pressure on admission ≥ 160 mmHg (OR=3.058; 95% CI 1.781~5.249; P<0.001) were independent risk factors for rebleeding. Conclusions For the patients with RIA, if the time from onset to hospitalization is long, the aneurysm is large, and the preoperative control of blood pressure is not satisfactory, the treatment for the aneurysm should be adopted as soon as possible to reduce the rebleeding rate.