颅内动脉瘤破裂出血介入术后发生脑疝的危险因素分析

Analysis of risk factors of cerebral hernia after interventional therapy for ruptured intracranial aneurysm hemorrhage

目的 研究颅内动脉瘤破裂出血介入术后发生脑疝的危险因素.方法 回顾性分析86例实施介入治疗的颅内动脉瘤破裂出血患者的临床资料,将患者根据患者术后是否并发生脑疝进行分组,分析影响术后脑疝发生的危险因素,并提出防治策略.结果 86例患者中,15例术后发生脑疝,发生率为17.44%.发生组年龄>60岁、改良Fisher分级>Ⅱ级、Hunt-Hess分级>Ⅲ级、有高血压病史及宽颈动脉瘤的患者占比高于未发生组,且多因素Logistic回归分析结果证实上述因素均为导致介入术后发生脑疝的独立危险因素(P<0.05).结论 颅内动脉瘤破裂出血介入术后患者发生脑疝的几率较高,年龄、改良Fisher分级、Hunt-Hess分级等均是其独立危险因素,针对以上因素应做好介入术后脑疝预防干预措施.

Objective To study the risk factors of cerebral hernia after interventional therapy for ruptured intracranial aneurysm hemorrhage. Methods The clinical data of 86 patients with ruptured intracranial aneurysms hemorrhage treated by interventional therapy were analyzed retrospectively. According to whether they had cerebral hernia after operation, the patients were divided into groups. The risk factors influencing the occurrence of cerebral hernia after operation were analyzed, and the prevention and treatment strategies were put forward. Results Among the 86 patients, 15 patients developed cerebral hernia, and the incidence was 17.44%. The proportions of patients with age >60 years old, improved Fisher grade >Ⅱ, Hunt-Hess grade >Ⅲ, has hypertension history and wide neck aneurysm in the occurrence group were higher than those in the non-occurrence group, and the multivariate Logistic regression analysis results confirmed that the above factors were independent risk factors for cerebral hernia after intervention(P<0.05). Conclusion The incidence of cerebral hernia is higher in patients with ruptured intracranial aneurysms hemorrhage after interventional therapy. The independent risk factors are age, improved Fisher grade, Hunt-Hess grade, etc. In view of the above factors, preventive interventions for cerebral hernia after interventional therapy should be done well.