影响颅内多发囊性动脉瘤预后的相关因素分析

目的 探讨影响颅内多发囊性动脉瘤预后的相关因素.方法 回顾分析我科2008年1月到2009年12月间的35例颅内多发动脉瘤患者的完整资料,根据患者具体情况,按实施治疗方案分手术、介入、手术加介入三组.术前患者评估内容包括:年龄、性别、动脉瘤数量、部位、侧别、大小、Hunt-Hess分级、Fisher分级.术后评估则以出院时GOS术后评分为准.单因素分析术前各因素、治疗方案对治疗效果的影响,多因素Logistic多元回归分析治疗效果与术前各因素、治疗方案的关系.结果 按GOS术后评分良好(4～5分)24例,差(1～2)11例.三组治疗效果比较差异没有统计学意义.通过统计学单因素分析,显示患者年龄、术前Hunt-Hess分级和Fisher分级与预后具有显著相关性(P＜0.30,参考相关文献).而多因素的Logistic多元回归分析结果显示患者年龄、术前Hunt-Hess 分级和Fisher分级有没有显著相关性(P＞0.05).结论 患者年龄、术前Hunt-Hess分级和Fisher分级是影响颅内多发动脉瘤患者术后疗效的关键因素,合理的治疗方案是提高颅内多发囊性动脉瘤疗效的关键.

Analysis on prognosis factors of multiple intracranial aneurysms

Objective To investigate the prognosis factors of multiple intracranial aneurysms. Methods The clinical data of 35 patients with multiple intracranial aneurysms, who were treated in Department of Neurosurgery, Wuhan General Hospital, Guangzhou Command of PLA, from January 2008 to December 2009, were analyzed retrospectively. All the patients were divided into three groups, operation group, intervention group, and operation ＋ intervention group. Pre-operative evaluation included age, gender, number of aneurysms, location, suffered side, size, pre-operative Hunt-Hess grades, pre-operative Fisher grades. According to the Glasgow Outcome Scale, the outcome at discharge was divided into tw6 categories ： favorable （grade 4-5） or unfavorable （grade 1-3）. The effect of pre-operative factors and therapeutic scheme on prognosis was analyzed by Chi-square test. The correlation between pre-operative factors, therapeutic scheme and outcome was analyzed by Logistic muhivariable analysis. Results Favorable outcome was achieved in 24 cases and unfavorable in 11 cases. Age, pre-operative Hunt-Hess grades and Fisher grades were correlated with the outcome by single factor analysis （P 〈0. 30, referring to the related literatures）. Logistic multivariable regression analysis showed that no factor was correlated with the outcome （P 〉0. 05）. Conclusion Age, pre-operative Hunt-Hess grades and Fisher grades are the important factors which affect the prognosis of patient with multiple intracranial aneurysms. Appropriate therapeutic scheme is the key for the increasing effect of multiple intracranial aneurysms.