颅内动脉瘤血管内介入治疗术后复发的危险因素分析

Risk factors for recurrence of intracranial aneurysms after endovascular interventional therapy

目的 探讨颅内动脉瘤血管内介入治疗术后复发的危险因素。方法 收集2017年12月至2021年12月于蚌埠医学院第一附属医院接受介入治疗的99例颅内动脉瘤患者的临床资料,按照术后1年内动脉瘤是否复发分为复发组(n=21)和对照组(n=78)。比较两组患者介入治疗前的基本信息、治疗前体格检查结果、血液化验结果、术中造影检查结果、介入治疗相关指标以及术后1年随访影像学复查结果,分析颅内动脉瘤介入治疗术后1年内复发的影响因素。结果 复发组患者糖尿病、动脉瘤直径﹥10 mm、动脉瘤破裂、未使用支架比例均高于对照组患者,差异均有统计学意义(P﹤0.05)。多因素Logistic回归模型分析结果显示,糖尿病、大型动脉瘤、术前动脉瘤破裂、未使用支架辅助栓塞均是颅内动脉瘤介入治疗术后1年内复发的独立危险因素(P﹤0.05)。结论 糖尿病、大型动脉瘤、术前动脉瘤破裂、未使用支架辅助栓塞均是颅内动脉瘤介入治疗术后复发的危险因素,为临床医师对患者的初步风险评估提供参考,从而治疗方案,并对高危患者做好严密监测。

Objective To investigate the risk factors for recurrence of intracranial aneurysms after endovascular interventional therapy.Method The clinical data of 99 patients with intracranial aneurysms who received interventional treatment in the First Affiliated Hospital of Bengbu Medical College from December 2017 to December 2021 were collected.They were divided into recurrence group(n=21)and control group(n=78)according to whether the aneurysm recurred within one year after the operation.The pre-treatment basic information,pre-treatment physical examination results,blood test results,intraoperative angiographic examination results,interventional treatment related indicators,and postoperative one-year follow-up imaging review results were compared between the two groups of patients.The risk factors for intracranial aneurysm recurrence within one year after the interventional therapy were also analyzed.Result The proportions of diabetes,aneurysm diameter>10 mm,aneurysm rupture,and no stent use in the recurrence group were higher than those in the control group,the differences were statistically significant(P<0.05).The results of multivariate Logistic regression model analysis showed that diabetes,large aneurysm,preoperative aneurysm rupture,and non-use of stent-assisted embolization were all independent risk factors for intracranial aneurysm recurrence within one year after the interventional therapy(P<0.05).Conclusion Diabetes,large aneurysm,preoperative aneurysm rupture,and non-use of stent-assisted embolization are all risk factors for recurrence after the intracranial aneurysm intervention.These factors provide clinicians with a reference for the initial risk assessment of patients,to help the clinical workers better optimize the treatment regimen and closely monitor high-risk patients.