| 血管内治疗颅内破裂动脉瘤后发生神经系统并发症的相关因素分析 |
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| 引用本文： | 申屠华松,陈亦华,程振宇,邵林华,郑龙,俞建华,傅斌,毛根军. 血管内治疗颅内破裂动脉瘤后发生神经系统并发症的相关因素分析[J]. 中华全科医学, 2019, 17(1): 55-58. DOI: 10.16766/j.cnki.issn.1674-4152.000598 |
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| 作者姓名： | 申屠华松 陈亦华 程振宇 邵林华 郑龙 俞建华 傅斌 毛根军 |
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| 作者单位： | 1. 金华市人民医院神经外科, 浙江 金华 321000; |
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| 基金项目： | 浙江省医药卫生科技项目(2014ZDA028) |
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| 摘 要： | 目的分析颅内破裂动脉瘤(rupture intracranial aneurysms,RIAs)患者血管内治疗(endovascular treatment,EVT)相关的神经系统并发症的影响因素,为RIAs患者的EVT治疗提供参考。方法选取2012年3月—2017年1月在金华市人民医院诊断且符合纳入标准的75例RIAs患者为研究对象,对其行EVT治疗,术后随访6个月,根据术后EVT治疗相关的神经系统并发症发生情况,将术后出现EVT相关神经系统并发症的患者纳入并发症发生组(24例),将术后未出现相关并发症的患者纳入并发症未发生组(51例),对比2组患者的一般资料(性别、年龄、高血压、糖尿病、脑梗死病史、Hunt-Hess分级、Fisher分级等)、动脉瘤相关指标(动脉瘤的数量、最大直径、位置、形态、瘤囊及主动脉弓分型情况等)、EVT治疗情况(手术次数、手术方式、破裂至栓塞时间、栓塞效果及血钠水平)的差异,并采用二元Logistic回归分析影响RIAs患者EVT治疗相关的神经系统并发症的因素。结果并发症未发生组患者的高血压、Hunt-Hess分级、Fisher分级、瘤囊、宽颈动脉瘤情况、手术方式及血钠水平与并发症发生组比较,差异有统计学意义(均P <0. 05);患者的Hunt-Hess分级、手术方式、瘤囊及宽颈动脉瘤情况是影响RIAs患者EVT治疗相关神经系统并发症的主要因素。结论 Hunt-Hess分级、手术方式、瘤囊及宽颈动脉瘤情况是RIAs患者EVT治疗相关的神经系统并发症的影响因素。
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| 关 键 词： | 颅内破裂动脉瘤 血管内治疗 神经系统并发症 影响因素 |
| 收稿时间： | 2018-08-10 |
Analysis of the influence factors of neurologic complications associated with endovascular treatment in patients with rupture intracranial aneurysms |
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| Affiliation: | Department of Neurosurgery, Jinhua People's Hospital, Jinhua, Zhejiang 321000, China |
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| Abstract: | Objective To analyze the influence factors of neurologic complications associated with endovascular treatment (EVT) in patients with rupture intracranial aneurysms (RIAs) and provide a reference for the clinical treatment of EVT in RIAs patients. Methods A total of 75 cases of RIAs meeting the inclusion criteria in our hospital from Mach 2012 to January 2017 were enrolled into this study. The patients were treated with EVT and followed up for 6 months. According to the neurologic complications after EVT therapy, the patients with EVT associated neurological complications were included in the complication group (n=24), and the patients without the associated complications were included in the uncomplicated group (n=51). The general data (gender, age, hypertension, diabetes, cerebral infarction history, HuntHess classification and CT Fisher classification, etc), aneurysms related indicators (the number of aneurysms, the maximum diameter, position, shape, tumor cyst and aortic arch typing. etc) and EVT treatment (surgical procedures, surgical methods, rupture to embolization time, embolization effect and blood sodium level) were compared between the two groups. The binary logistic was performed to analyze the influence factors of neurologic complications associated with EVT in RIAs patients. Results The hypertension, Hunt-Hess classification, Fisher classification, tumor cyst, wide-necked aneurysm, surgical methods and blood sodium level in uncomplicated group were significantly differences with the complication group (P < 0.05). The main influence factors of neurologic complications in RIAs associated with EVT were the Hunt-Hess classification, surgical methods, tumor cyst and wide-necked aneurysm. Conclusion The Hunt-Hess classification, surgical methods, tumor cyst and wide-necked aneurysm are the influence factors of neurologic complications associated with EVT in RIAs patients. |
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| Keywords: | Ruptured intracranial aneurysms Endovascular treatment Neurologic complications Influence factors |
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