破裂颅内动脉瘤介入治疗的预后因素分析

Prognostic factors in interventional treatment of ruptured intracranial aneurysms

摘要:

目的 探讨介入治疗破裂颅内动脉瘤（IA）患者预后的影响因素。方法 回顾性分析2015 年 1 月—2018 年6 月绍兴市人民医院113 例行血管内介入治疗的破裂IA 患者的临床资料。采用改良Rankin 量 表（mRs）评价预后，根据随访结果分为预后良好组（mRs 评分0 ～ 1 分）和预后不良组（mRs 评分2 ～ 6 分）。 对可能影响预后的因素进行单因素分析和多因素Logistic 回归分析。结果 113 例患者中，83 例（73%）预后 良好，30 例（27%）预后不良。单因素分析结果显示，年龄、Hunt-Hess 分级、Fisher 分级、手术时机及脑积 水对预后有影响（P <0.05）。多因素Logistic 回归分析结果显示，年龄[Ol ^ R=1.065（95% CI ：1.012，1.121）]、 Hunt-Hess 分级[Ol ^ R=9.497（95% CI ：2.034，44.345）]、手术时机[Ol ^ R=3.957（95% CI ：1.242，12.604）] 及 脑积水[Ol ^ R=8.005（95% CI ：1.552，41.278）] 为影响预后的独立危险因素。结论 年龄、Hunt-Hess 分级、 手术时机及脑积水能够影响行介入治疗的破裂IA 患者预后。

Abstract:

Objective To investigate the prognostic factors in interventional treatment of ruptured intracranial aneurysms. Methods The clinical data of 113 cases of ruptured intracranial aneurysms treated by endovascular treatment from January 2015 to June 2018 were retrospectively reviewed. The outcome was measured by the modified Rankin scale (mRs) and was dichotomized into favourable group (mRs 0 to 1) and unfavorable group (mRs 2 to 6). The potential factors for unfavorable outcome were evaluated by a univariate analysis and multivariate logistic regression analysis. Results Among the 113 patients, 83 (73%) patients had a favorable outcome, 30 (27%) patients had an unfavorable outcome. Univariate analysis indicated that age, Hunt-Hess grade, Fisher grade, timing of operation, hydrocephalus were significantly correlated with the prognosis (P < 0.05). Multivariate logistic regression analysis indicated that age [Ol ^ R = 1.065 (95% CI: 1.012, 1.121)], Hunt-Hess grade [Ol ^ R=9.497 (95% CI: 2.034, 44.345)], timing of operation [Ol ^ R=3.957 (95% CI: 1.242, 12.604)] and hydrocephalus [Ol ^ R=8.005 (95% CI: 1.552, 41.278)] were the factors affecting the prognosis for interventional treatment of ruptured intracranial aneurysms. Conclusions Age, Hunt-Hess grade, timing of operation and hydrocephalus can significantly affect the prognosis of the patients for interventional treatment of ruptured intracranial aneurysms.