破裂前交通动脉瘤术后患者认知功能及预后的临床研究

Clinical study on cognitive function and prognosis of patients with ruptured anterior communicating artery aneurysm after operation

目的研究破裂前交通动脉瘤手术治疗后患者的认知功能及预后情况。方法回顾性分析山西医科大学第一医院神经外科自2015年3月至2017年6月连续收治的94例破裂前交通动脉瘤患者的临床资料,应用认知功能电话问卷修订版及工具性日常生活能力量表、改良Rankin量表评价术后患者的认知功能及预后。采用单因素分析及多因素Logistic回归分析术后患者认知功能与预后的影响因素。结果67例患者完成了术后认知功能及预后的随访评价。单因素分析:Hunt-Hess分级、文化程度是术后患者认知功能的影响因素(P<0.05);Hunt-Hess分级、Fisher分级、年龄、文化程度是患者预后的影响因素(P<0.05)。进一步行多因素分析,高文化程度是术后患者认知功能的独立影响因素(OR=0.073,95%CI:0.008~0.638,P=0.018)。结论高文化程度是术后患者认知功能的独立影响因素,且是保护因素。

Objective To investigate the cognitive function and prognosis of patients with ruptured anterior communicating aneurysm after surgical treatment.Methods Retrospective analysis was made on the clinical data of 94 consecutive patients with ruptured anterior communicating aneurysm admitted to Neurosurgery Department of The First Hospital of Shanxi Medical University from March 2015 to June 2017.The cognitive function and prognosis of postoperative patients were evaluated by means of telephone interview for cognitive status-modified,instrumental daily living ability scale and modified Rankin scale.Univariate analysis and multifactorial Logistic regression analysis were used to analyze the influencing factors of postoperative patients’cognitive function and prognosis.Results Follow-up evaluation of postoperative cognitive function and prognosis was completed in 67 patients.Univariate analysis:Hunt-Hess grade and degree of education were influential factors for postoperative cognitive function in patients(P<0.05).Hunt-Hess grade,Fisher grade,age and degree of education were influential factors for prognosis of the patients(P<0.05).Further multi-factor Logistic analysis showed that high education level was an independent factor affecting postoperative cognitive function of patients(OR=0.073,95%CI:0.008-0.638,P=0.018).Conclusion High educational level is an independent and protective factor of postoperative cognitive function.