颅内动脉瘤栓塞术后再出血原因分析

Analysis of causes of rebleeding after embolization of intracranial aneurysms

目的探讨颅内动脉瘤患者在接受血管内介入栓塞手术后发生动脉瘤再破裂出血的原因,以降低再出血风险。方法回顾性分析2021年1月至2023年1月收治的颅内动脉瘤破裂行介入栓塞术的患者临床资料。159例接受介入栓塞患者中发生术后动脉瘤再次破裂出血18例,采用单因素和多元Logistic回归分析影响动脉瘤栓塞术后破裂再出血的危险因素。结果年龄、高血压、H-H分级、动脉瘤大小、动脉瘤形状、动脉瘤栓塞程度等因素的差异有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄>60岁、合并高血压病史、动脉瘤直径>10mm、动脉瘤形状不规则、H-H分级>3级、部分栓塞是动脉瘤栓塞术后破裂再出血的独立高危因素。结论颅内动脉瘤栓塞术后再破裂出血是一种严重危机生命的并发症,通过降低危险因素可减少术后破裂再出血发生。

Objective To investigate the causes of re-rupture and bleeding of aneurysms in patients with intracranial aneurysms after endovascular interventional embolization to reduce the risk of re-bleeding.Methods The clinical data of consecutive patients admitted for interventional embolization of ruptured intracranial aneurysms from January 2021to January 2023were retrospectively analyzed.Eighteen of 159patients who underwent interventional embolization had re-rupture and bleeding of the aneurysm after the procedure.Results The differences in age,hypertension,H-H classification,aneurysm size,aneurysm shape,and degree of aneurysm embolization were statistically significant(P<0.05).Multi-factor logistic regression analysis showed that the age>60years old,history of hypertension,aneurysm diameter>10mm,irregular shape of aneurysm,H-H grade>3,and partial embolism were independent high risk factors for rupture and rebleeding of aneurysm after embolization.Conclusion Re-rupture haemorrhage after intracranial aneurysm embolisation is a serious life-threatening complication,and its occurrence can be reduced by reducing risk factors.