血管内栓塞治疗后交通动脉瘤的预后观察及相关因素分析

Prognosis and its related factors in posterior communicating artery aneurysm treated with endovascular embolization

目的观察血管内栓塞治疗后交通动脉瘤患者的预后,并探讨影响其预后的危险因素。方法回顾性分析60例后交通动脉瘤患者的临床资料,均接受血管内栓塞治疗。观察栓塞效果及预后,并分析影响患者预后的危险因素。结果栓塞后即刻Raymond分级:完全栓塞36例,近全栓塞18例,部分栓塞6例。预后良好42例,预后不良18例。预后良好组与预后不良组动脉瘤直径、手术时机、术前Hunt-Hess分级、术后是否发生脑梗死比较,差异有统计学意义(均P<0.05)。多因素Logistic回归分析显示:动脉瘤直径大、手术时机>14 d、术前Hunt-Hess分级高、术后脑梗死是影响血管内栓塞治疗后交通动脉瘤患者预后的独立危险因素(均P<0.05)。结论血管内栓塞治疗后交通动脉瘤患者预后良好,同时应注意动脉瘤直径大、手术时机>14 d、术前Hunt-Hess分级高、术后脑梗死对患者预后的影响。

Objective To observe the prognosis in patients with posterior communicating artery aneurysm treated with endovascular embolization, and to explore the risk factors affecting its prognosis. Methods The clinical data of 60 patients with posterior communicating artery aneurysm were retrospectively analyzed, and all underwent endovascular embolization. The embolization effect and prognosis were observed, and the risk factors affecting prognosis were analyzed in patients. Results The Raymond classification instantly after embolization was as follows: total embolization in 36 cases, nearly total embolization in 18 cases, and partial embolization in 6 cases. Forty-two cases achieved favorable prognosis and 18 cases had poor prognosis. There were statistically significant differences in aneurysm diameter, operation timing, preoperative Hunt-Hess classification, presence of postoperative cerebral infarction between the two groups(all P<0.05). Multivariate logistic regression analysis revealed that large aneurysm diameter, operation timing more than 14 days, high Hunt-Hess classification before operation, and postoperative cerebral infarction were the independent risk factors affecting prognosis in patients with posterior communicating artery aneurysm(all P<0.05). Conclusion Patients with posterior communicating artery aneurysm treated with endovascular embolization achieves a preferable prognosis;in addition, attention should be paid to the effects of the factors on prognosis in patients, such as large aneurysm diameter, operation timing more than 14 days, high Hunt-Hess classification before operation, and postoperative cerebral infarction.