颅内动脉瘤患者术前Hunt-Hess分级、手术时机对血管内栓塞治疗预后的影响

Influence of preoperative Hunt-Hess classification, operation timing of endovascular embolization on the prognosis of patients with intracranial aneurysm

目的 探讨颅内动脉瘤患者术前Hunt-Hess分级、手术时机对血管内栓塞治疗预后的影响。方法 回顾性分析2018年3月至2021年8月在西安市第九医院、渭南市中心医院行血管内栓塞治疗的76例颅内动脉瘤患者为的临床资料,其中预后良好组64例,预后不良组12例;采用多元Logistic回归分析分析影响颅内动脉瘤患者血管内栓塞治疗预后的危险因素。结果 两组患者在性别、年龄、糖尿病、高血压、动脉瘤直径及位置、瘤颈方面比较差异均无统计学意义(P>0.05);预后良好组和预后不良组患者在手术时机、Fisher分级、术前Hunt-Hess分级方面比较差异均具有统计学意义(P<0.05);经多元Logistic回归分析结果显示,手术时机、Fisher分级、术前Hunt-Hess分级为颅内动脉瘤患者血管内栓塞治疗预后不良的独立危险因素(P<0.05)。结论 手术时机、Fisher分级、术前Hunt-Hess分级为颅内动脉瘤患者血管内栓塞治疗预后不良的独立危险因素。

Objective To investigate the effect of preoperative Hunt-Hess classification, operation timing of endovascular embolization on the prognosis of patients with intracranial aneurysm. Methods The clinical data of 76 patients with intracranial aneurysms who underwent endovascular embolization in the Ninth Hospital of Xi’an and Weinan Central Hospital from March 2018 to August 2021 were retrospectively analyzed. There were 64 cases in the good prognosis group and 12 cases in the poor prognosis group. Multiple Logistic regression analysis was used to analyze the risk factors affecting the prognosis of endovascular embolization in patients with intracranial aneurysms. Results There was no significant difference in gender, age, diabetes, hypertension, aneurysm diameter and location, and aneurysm neck between the two groups(P>0.05). There were significant differences in operation time, Fisher grade, and preoperative Hunt-Hess classification between good prognosis group and poor prognosis group(P<0.05). Multivariate logistic regression analysis showed that operation timing, Fisher grade, and preoperative Hunt-Hess classification were independent risk factors for poor prognosis(P<0.05). Conclusion Operation timing, Fisher grade, preoperative Hunt-Hess classification are independent risk factors for poor prognosis in patients with intracranial aneurysm treated with endovascular embolization.