开颅动脉瘤夹闭术后发生脑积水的危险因素

Risk Factors for Hydrocephalus After Intracranial Aneurysm Clipping

目的探讨开颅动脉瘤夹闭术后发生脑积水的危险因素。方法回顾性分析2018年1—12月于新乡医学院附属商丘市第一人民医院接受开颅动脉瘤夹闭术治疗的109例患者的临床资料。根据术后是否发生脑积水将患者分为非脑积水组(86例)和脑积水组(23例)。分析脑积水与临床指标的关系。采用多因素logistic回归模型分析开颅动脉瘤夹闭术后发生脑积水的危险因素。结果脑积水组吸烟史、入院时改良Fisher分级、术前急性脑积水、术后颅内感染、术后去骨瓣分别与非脑积水组比较,差异有统计学意义(均P<0.05)。多因素logistic回归结果显示,术后去骨瓣、入院时改良Fisher分级较高、吸烟史、术前急性脑积水是开颅动脉瘤夹闭术后发生脑积水的独立危险因素(均P<0.05)。结论术后去骨瓣、入院时改良Fisher分级较高、吸烟史、术前急性脑积水是开颅动脉瘤夹闭术后发生脑积水的独立危险因素。

Objective To explore the risk factors of hydrocephalus after intracranial aneurysm clipping.Methods The clinical data of 109 patients who underwent intracranial aneurysm clipping in Shangqiu First People’s Hospital Affliated to Xinxiang Medical University from January to December 2018.The patients were divided into non-hydrocephalus group(86 cases)and hydrocephalus group(23 cases)according to whether hydrocephalus occurred after operation.To analyze the relationship between hydrocephalus and clinical indicators.Multivariate logistic regression model was used to analyze the risk factors of hydrocephalus after intracranial aneurysm clipping.Results The smoking history,modified Fisher classification at admission,preoperative acute hydrocephalus,postoperative intracranial infection and postoperative bone flap removal in hydrocephalus group were statistically different from those in non-hydrocephalus group(all P<0.05).Multivariate logistic regression showed that postoperative bone flap removal,higher improved Fisher classification at admission,smoking history and preoperative acute hydrocephalus were independent risk factors for hydrocephalus after intracranial aneurysm clipping(all P<0.05).Conclusion The independent risk factors for hydrocephalus after intracranial aneurysm clipping are postoperative bone flap removal,higher improved Fisher classification at admission,smoking history and preoperative acute hydrocephalus.