影响血管内介入治疗颅内动脉瘤预后的相关因素分析

目的探讨血管内介入治疗颅内动脉瘤影响预后的危险因素。方法收集2009年1月～2012年5月我院神经外科经血管内介入治疗的147例颅内动脉瘤患者的临床资料，并随访10个月，采用GOS评分评估预后，对11个可能影响患者预后的因素进行单因素和多因素Logistic回归分析。结果单因素分析显示Hunt—hess分级、动脉瘤位置、瘤颈宽度、基础病、高血压病是影响预后的危险因素（P〈0．05）。多因素Logistic回归分析显示，Hunt—hess分级（Ⅲ、Ⅳ级）、动脉瘤位于后循环动脉、瘤颈≥4mm、有高血压病史为预后不良的独立危险因素（OR分别为15．561、1．973、3．625、6．483，均P〈0．05）。结论Hunt—hess分级（Ⅲ、Ⅳ级）、动脉瘤位于后循环动脉、瘤颈≥4mm、有高血压病史是血管内介入治疗颅内动脉瘤预后不良的独立危险因素。

Analysis of the Associated Factors Influencing Endovascular Treatment of Intracranial Aneurysms

Objective To study risk factors influencing the outcome for endovascular treatment of intracranial aneurysms. Methods The clinical data of 147 patients enrolled between January 2009 and May 2012 were reviewed. A total of 11 potential factors associated with poor outcome of endovascular treatment of intracranial aneurysms were evaluated by univariate analysis and multivariate Logistic regression analysis. Results The univariate analysis showed that Hunt-hess grade, tumor location, the width of the aneurysm neck, underlying diseases, and hypertension were significantly different between patients with poor outcome and good outcome after endovascular treatment （P〈0.05）. Multivariate Logistic regression analysis showed that Hunt-hess grade （Ⅲ、Ⅳ ） （OR ： 15. 561, P〈0. 05 ）, tumor location（Posterior circulation artery） （OR = 1. 973, P〈0.05 ）, neck width≥ 4 mm（OR = 3. 625, P〈0. 05 ）, hypertension（OR = 6. 483, P 〈0. 05）were independent risk factors for endovascular treatment of intracranial aneurysms. Conclusion Hunt-hess grade, tumor location, the width of the aneurysm neck, the underlying diseases, and hypertension were associated with poor outcome of endovascular treatment of intraeranial aneurysms. Hunt-hess grade（ Ⅲ、Ⅳ ）,tumor location（Posterior circulation artery）,neck width ≥4mm, and hypertension were independent risk factors for the outcome of intracranial aneurysms with endovascular treatment.