介入治疗颅内动脉瘤破裂出血的预后因素分析

目的 探讨行血管内治疗的颅内动脉瘤(AN)破裂出血患者预后的影响因素,降低其并发症的发生,提高治疗效果. 方法 选取广州军区武汉总医院神经介入中心自2002年1月至2007年4月应用血管内治疗的206例AN破裂出血患者,分析其临床资料并对影响患者预后的因素进行单因素、多因素Logistic回归分析.结果 单因素Logistic回归分析结果显示Hunt-Hess分级,多次出血,治疗时机和Fisher分级对预后的影响具有统计学意义(P<0.05);非条件多因素Logistic回归分析结果显示Hunt-Hess分级、治疗时机、Fisher分级是影响AN破裂血管内治疗预后的独立危险因素(P=0.000).结论 选择合适的治疗时机,积极预防脑血管痉挛(CVS)等并发症、有效的清除蛛网膜下腔的的积血是提高预后优良率的关键.

Prognostic factors in interventionai treatment of intracranial aneurysm rupture

Objective To investigate the influential factors to the prognosis of patients with rupture and haemorrhage of aneurysm (AN) after performing endovascular treatment, reduce the incidence of its complications and improve its remedial effects. Methods The data of 206 patients with rupture and haemorrhage of AN after performing endovasenlar treatment were retrospectively analyzed. These patients were admitted to our hospital from January 2002 to April 2007. We used single and multiple factor logistic regression methods to analyze the factors affecting the prognosis of the disease. Results Single factor logistic regression showed that such factors as the Hunt-Hess grading, the Fisher grading, repeated haemorrhage and the treating time had significant differences in affecting the prognosis of patients with rupture and haemorrhage of AN (P<0.05). Multiple factor non-conditional logistic regression showed that the Hunt-Hess grading, the treating time and the Fisher grading with the odds radio (OR) of 3.5448, 5.2975 and 7.2361, respectively, were independent risk factors that affect the prognosis of patients with rupture and haemorrhage of AN after endovascular treatment. Conclusion Choosing the optimal treating time, preventing such complications as cerebral vasospasm and clearing the blood of subarachnoid hemorrhage effectively are the keys to improve the prognosis of this disease.