栓塞治疗对老年未破裂颅内动脉瘤患者头痛的效果及影响因素分析

Analysis of the effect and influencing factors of embolotherapy on headache in elderly patients with unruptured intracranial aneurysms

目的探索栓塞治疗对老年未破裂颅内动脉瘤患者头痛的效果及影响因素。方法回顾性分析2018年1月至2020年12月我科收治的老年(≥61岁)未破裂颅内动脉瘤患者临床资料, 利用11点头痛定量评分法对所有患者的术前及术后6个月头痛程度进行定量评估, 分析术前与术后的头痛差异, 并对影响头痛结果的相关因素进行单因素分析。结果共73例患者(年龄61~86岁, 平均68.4岁, 女47例)符合纳入标准, 53例(72.6%)伴有术前头痛(评分≥1分), 其中39例(73.6%)术后头痛症状减轻, 11例(20.8%)术后头痛无改变, 3例(5.7%)术后头痛加重。术前平均头痛评分5(4, 6), 术后平均评分3(1, 4), 两者间差异有统计学意义(Z=-5.036, P=0.000)。术前头痛评分与术后头痛结果相关, 术前评分越高术后改善越差(Z=-2.819, P=0.005)。结论未破裂颅内动脉瘤栓塞治疗可以缓解多数老年患者的头痛症状, 术前头痛严重程度与术后头痛结果相关。

ObjectiveTo analyze the effect and influencing factors of embolotherapy on headache in elderly patients with unruptured intracranial aneurysms.MethodsAretrospective analysis of clinical data of elderly patients(aged≥61 years)with unruptured intracranial aneurysms admitted to our hospital from January 2018toDecember 2020 was performed.Headache assessment was performed by a quantitative ll-point headache scale in all patients preoperatively and at 6 months after endovascular treatment,and the difference between them was analyzed.Univariate analysis was applied to test the association between headache outcomes and clinical variables.Results A total of 73 patients(mean age:68.4 years old;age range:61-86 years;47 women)fulflled the inclusion criteria.There were 53 patients(72.6%)who presented with preoperative headache(headache score≥1).Among them,39 cases(73.6%)had an improvement in headache,11(20.8%)remained unchanged,and 3(5.7%)aggravated,after endovascular treatment.The average preoperative headache score was 5(4,6)us.postoperative 3(1,4),with statistical significance(Z=-5.036,P=0.000).Only the preoperative headache score was associated with outcomes of headache,and a higher headache score predicted a lack of headache relief(Z=-2.819,P=0.005).ConclusionsEmbolotherapy of unruptured intracranial aneurysms can relieve headache in most elderly patients.Preoperative headache severity is correlated with postoperative headache outcomes.