颅内动脉瘤性蛛网膜下腔出血患者血管内介入治疗效果的影响因素分析

Analysis of influencing factors of effect of endovascular interventional therapy in patients with intracranial aneurysmal subarachnoid hemorrhage

目的探讨颅内动脉瘤性蛛网膜下腔出血(aSAH)患者血管内介入治疗效果的影响因素。方法选择行血管内介入治疗的85例颅内aSAH患者作为研究对象,参照格拉斯哥结局量表(GOS)评分将其分为疗效良好组与疗效不佳组。收集两组的临床资料,分析影响颅内aSAH患者血管内介入治疗效果的因素。结果85例颅内aSAH患者中,疗效良好者32例,疗效不佳者53例。单因素分析结果显示,两组的高血压史、多发性动脉瘤、手术时间、发病至治疗时间、术前Hunt-Hess分级、术前改良CT-Fisher分级、引流方式比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高血压史、多发性动脉瘤、发病至治疗时间、术前Hunt-Hess分级、术前改良CT-Fisher分级是影响颅内aSAH患者血管内介入治疗效果的危险因素,引流方式是保护因素(P<0.05)。结论颅内aSAH发病后应尽早行血管内介入治疗,监测术前Hunt-Hess分级、术前改良CT-Fisher分级,评估高血压史、多发性动脉瘤等因素,以确保患者的治疗效果。

Objective To investigate the influencing factors of endovascular interventional therapy in patients with intracranial aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 85 patients with intracranial aSAH who underwent endovascular interventional therapy were selected as the research objects.According to the Glasgow Outcome Scale(GOS)score,the patients were divided into good efficacy group and poor efficacy group.The clinical data of the two groups were collected to analyze the factors affecting the effect of endovascular interventional therapy in patients with intracranial aSAH.Results Among 85 patients with intracranial aSAH,32 had good efficacy and 53 had poor efficacy.Univariate analysis results showed that there were statistically significant differences in hypertension history,multiple aneurysms,operation time,time from onset to treatment,preoperative Hunt-Hess grade,preoperative modified CT-Fisher grade and drainage method between the two groups(P<0.05).Multivariate Logistic regression analysis results showed that hypertension history,multiple aneurysms,time from onset to treatment,preoperative Hunt-Hess grade and preoperative modified CT-Fisher grade were risk factors affecting the effect of endovascular interventional therapy in patients with intracranial aSAH,and drainage method was a protective factor(P<0.05).Conclusion Endovascular interventional therapy should be performed as soon as possible after the onset of intracranial aSAH,the preoperative Hunt-Hess grade and preoperative modified CT-Fisher grade should be monitored,and the hypertension history,multiple aneurysms and other factors should be evaluated to ensure the therapeutic effect of patients.