颅内多发动脉瘤外科治疗的临床研究

目的研究颅内多发动脉瘤外科治疗的临床特点。方法回顾分析63例颅内多发动脉瘤病人的临床资料，将出院时的GOS评分作为预后良好（4—5级），差（1—3级），分别评价了年龄、性别、治疗手段、术前Hunt—Hess分级、Fisher分级、动脉瘤部位、侧别、大小、数量等因素的影响。结果GOS评分预后良好49例，差14例。单因素分析显示术前Hunt—Hess分级和Fisher分级与预后相关（P〈0．05）。多因素的Logistic回归分析结果显示各因素与预后均无明显相关（P〉0．05）。结论术前Hunt—Hess分级和Fisher分级会影响颅内多发动脉瘤病人的疗效，治疗方案的选择会提高其疗效。手术和介入的治疗效果未见明显差异。

Clinical research on the surgery of multiple intracranial aneurysms

Objective To explore the clinical characteristics of multiple intracranial aneurysms. Methods 63 patients with multiple intracranial aneurysms were reviewed. The patient＇ s outcome at discharge according to the Glasgow Outcome Scale was divided into two categories ： favorable （4 - 5 grades ） or unfavorable （ 1 - 3 grades）. Those factors that might influence the outcome were evaluated, including gender, age, treatment methods, preoperative Hunt-Hess grades, preoperative Fisher grades, the location and lateral side and size and number of the aneurysms. Results Favorable outcome in 49 cases ,unfavorable in 14cases. The preoperative Hunt-Hess grades and Fisher grades were predictors for the outcome by univariable analysis （ P 〈 0.05 ）. The results of multiple Logistic regression analysis showed that no factor was predictors for the outcome （ P 〉 0.05 ）. Conclusions The patients with bad preoperative Hunt-Hess grades and Fisher grades may have unfavorable outcome. However, good treatment will improve the outcome. There is no significant difference in outcome between open surgery and endovascular treatment groups.