颅内破裂微小动脉瘤预后的影响因素分析

目的探讨颅内破裂微小动脉瘤预后的影响因素。方法回顾性分析2012年11月至2016年8月手术治疗的63例颅内破裂微小动脉瘤的临床资料,采用多因素Logistic回归分析检验预后影响因素。结果术后6个月,采用GOS评分评估预后,预后良好(GOS评分4~5分)41例,预后不良22例。多因素Logistic回归分析显示入院时Hunt-Hess分级Ⅲ级(OR=11.453,95%CI:1.888~69.495,P=0.008)、合并脑内血肿(OR=6.665,95%CI:1.298~34.236,P=0.023)、合并脑梗死(OR=11.353,95%CI:1.909~67.520,P=0.008)是影响破裂颅内微小动脉瘤病人预后的独立影响因素。结论颅内破裂微小动脉瘤入院时Hunt-Hess分级Ⅲ级、合并脑内血肿、合并脑梗死,预后较差。这些因素可评估此类病人近期预后,指导临床诊治。

Analysis of factors related to prognoses in the patients with very small ruptured intracranial aneurysms treated by surgery

Objective To study factors related to the prognoses in the patients with very small ruptured intracranial aneurysms after the surgery. Methods The clinical data of 63 patients with very small ruptured intracranial aneurysms, who received surgical or endovascular treatment in our hospital from November, 2012 to August, 2016, were analyzed retrospectively. The relationships of prognoses with the factors including the patients' age and gender, operative approach and opportunity, Fisher Scale and Hunt-Hess classification on admission to hospital, intracerebral hematoma, and cerebral infraction were analyzed by univariate and multivariable logistic regression analyses. Results The univariate analysis showed that prognoses of patients with very small ruptured intracranial aneurysms were affected by Fisher Scale and Hunt-Hess classification on admission to hospital, intracerebral hematoma and cerebral infraction (P<0.01). The multivariate logistic regression analysis showed that Hunt-Hess classification (>grade Ⅲ) on admission to hospital (OR=11.453, 95%CI: 1.888~69.495, P=0.008), intracerebral hematoma (OR=6.665, 95%CI: 1.298~34.236, P=0.023) and cerebral infraction (OR=11.353, 95%CI:1.909~67.520, P=0.008) were independent risk factors affecting the prognoses in the patients with very small ruptured intracranial aneurysms. Conclusion The patients' Hunt-Hess classification on admission to hospital and whether patients were complicated by intracerebral hematomas and cerebral infractions are of high value to predicting the prognoses in the patients with very small intracranial aneurysms.