颅内动脉瘤术后并发症对其预后的影响

目的回顾性分析1994年3月至2004年1月期间因颅内动脉瘤而住院手术的病例，探讨术后并发症对颅内动脉瘤手术预后的影响。方法应用Logist回归模型对465例颅内动脉瘤患者发病时的神经系统体征及术后并发症等指标进行单因素和多因素分析。结果共手术治疗486枚动脉瘤，其中单发动脉瘤患者446例，多发动脉瘤患者19例（40枚动脉瘤）。患者发病时的血糖水平及各种并发症与患者预后有关，而年龄、性别、术前Fisher分级、术前GCS、术后是否静脉使用抗痉挛药物、动脉瘤破裂次数、手术时机、以及术中阻断供血动脉时间等因素与预后无关。本组病死率8、11％，预后良好率74．99％。结论通过对血糖水平、术后并发症等动脉瘤预后相关危险因素的分析可预测动脉瘤患者预后，并有效指导治疗，从而提高临床救治水平。

The influence of postoperative complications on the prognosis of intracranial aneurysm

Objective To study the influence of postoperative complications on the prognosis of intracranial aneurysm. Methods The clinical data of 465 patients from March 1994 to January 2004 were analyzed with the Logistic regression analysis model.Results Altogether 486 intracranial aneurysms were found in 465 cases. The prognosis was related to the value of blood sugar and the complications, while it had no relationship with the age and gender of patients, the Fisher grade of spontaneous arachnoid hemorrhage (SAH), the Glasgow coma scale (GCS) grading, the application of drugs preventing cerebral vasospasm (CVS), the timing of operation, and the duration of temporary clip of artery. The overall intracranial aneurysm mortality was 8.11%, while 74.9% had a favorable outcome and 16.99% were severely disabled.Conclusion The level of blood glucose and the complications are the influencing factors of prognosis of intracranial aneurysms. By the analysis of the influencing factors, the prognosis of patients can be foreseen, which will improve the treatment of intracranial aneurysms.