颅内动脉瘤术后早期脑缺血性并发症的多因素分析

目的探讨颅内动脉瘤开颅术后发生脑缺血症状的相关危险因素。方法回顾性分析291例颅内动脉瘤,根据术后是否发生缺血性并发症分组,对年龄、性别、有无高血压病史、入院Hunt-Hess分级、发病Fisher分级等11个指标进行多因素分析,探讨以上因素与术后发生脑缺血并发症的相关危险性。结果术后2周不可逆性脑缺血的发生率为14.1%(41/291),既往有高血压病史、术中动脉瘤处理方式复杂、术中发生动脉瘤破裂者发生脑缺血的危险系数分别为1.998、2.501和3.419(P<0.05)。结论对于颅内动脉瘤患者,高血压病史、术中动脉瘤处理方式、术中发生动脉瘤破裂可作为术后早期脑缺血发生的危险因素。

Multiple Factor Analysis of Early Post-operative Cerebral Ischemia of Intracranial Aneurysm

Objective Cerebral ischemia is one of the main factors affect prognosis of cerebral aneurysm. The related risk factors of cerebral ischemia after craniotomy treatment of intracranial aneurysm were discussed. Methods 291 intracranial aneurysm patients were investigated retrospectively in the study. They were grouped according to the post-operative cerebral ischemia complication. Multiple factor analyses were then carried out about age, gender, history of hypertension, Hunt-Hess grading at admission, Fisher grade of disease to discuss the relationship of above-mentioned factors with the occurrence of post-operative cerebral ischemia. Results The incidence of cerebral ischemia at 2 weeks after operation was 14.1% in this study. Hypertension history ( OR 1.998; 95% CI 1.15 to 3.47; P <0.05), complex operational method of aneurysm ( OR 2.501; 95% CI 1.33 to 4.69; P <0.01), rupture of aneurysm during operation ( OR 3.419; 95% CI 1.77 to 6.62; P <0.01) independently predicted worsened clinical outcome of cerebral ischemia early postoperation. Conclusion According the current data, the independent risk factors of post-operation early (2 weeks) cerebral ischemia include: history of hypertension, complex operation method and rupture during operation.