影响颅内动脉瘤显微手术患者预后的术前因素分析及手术的临床要点

Prognosis Influencing Factors of Intracranial Aneurysm Patients Treated by Microsurgery and Its Key Points

目的探讨影响颅内动脉瘤显微手术患者预后的术前因素,并总结颅内动脉瘤显微手术的临床要点。方法选取2010—2013年江西省人民医院同一动脉瘤显微手术组治疗的颅内动脉瘤患者360例,回顾性分析患者的临床资料、影像学资料及手术情况。分析不同年龄、有无高血压、不同手术时机及Hunt-Hess分级患者预后效果。结果≤60岁、有高血压、Hunt-Hess分级≤Ⅲ级患者的预后效果分别优于>60岁、无高血压及Hunt-Hess分级>Ⅲ级患者(P<0.05);不同手术时机患者预后效果比较,差异有统计学意义(P<0.05),其中早期手术和延期手术优于中期手术(P<0.05)。结论高龄、高血压、手术时机及Hunt-Hess分级是影响颅内动脉瘤显微手术患者预后的常见因素,重视术前影像学资料、术中充分降颅压是颅内动脉瘤显微手术的临床要点。

Objective To investigate the prognosis influencing factors of intracranial aneurysms patients treated by microsurgery and its key points. Methods A total of 360 intracranial aneurysms patients admitted to People＇s Hospital of Jiangxi Province were selected from 2010 to 2013,all of them were treated by microsurgery by same operation group. Clinical data,＆amp;nbsp;imaging data and operation timing were retrospectively analyzed,and prognosis was compared among patients with different age, with or without hypertension,different operation timing and Hunt-Hess grading. Results Prognosis of patients aged 60 years old or less was better than patients aged over 60 years old,prognosis of patients with hypertension was better than patients without hypertension,and prognosis patients with Hunt-Hess grading atⅢor lower was better than patients with Hunt-Hess grading at over Ⅲ（ P﹤0. 05 ）;prognosis of patients underwent early operation and delayed surgery was better than patients underwent medium-term surgery（P﹤0. 05）. Conclusion Advanced age,hypertension and Hunt-Hess grading are common prognosis influencing factors of intracranial aneurysms patients treated by microsurgery, pay attention to imaging data and reduce intracranial pressure are the key points.