摘要
目的探讨颅内破裂动脉瘤栓塞术后早期破裂再出血的相关危险因素。方法共纳入42例颅内破裂动脉瘤栓塞术后早期破裂再出血患者（研究组），同期随机抽取行颅内破裂动脉瘤栓塞术后早期未破裂再出血患者40例作为对照组。采用非条件Logistic回归模型进行单因素及多因素分析。结果单因素分析结果表明：研究组年龄I〉50岁、高血压病史、糖尿病病史、破裂次数≥2次、合并脑血管痉挛、术后抗凝治疗、术后血压波动≥30mmHg（1mmHg=0．133kPa）、假性动脉瘤、致命栓塞及大部分栓塞[81．0％（34／42）、76．2％（32／42）、66．7％（28／42）、76．2％（32／42）、81．0％（34／42）、76．2％（32／42）、66．7％（28／42）、66．7％（28／42）、66．7％（28／42）]与对照组[57．5％（23／40）、50．0％（20／40）、37．5％（15／40）、50．0％（20／40）、57．5％（23／40）、47．5％（19／40）、37．5％（15／40）、37．5％（15／40）、37．5％（15／40）]比较差异有统计学意义（P〈0．05）。进一步行多因素分析结果表明：年龄≥50岁、高血压病史、破裂次数≥2次、合并脑血管痉挛、术后抗凝治疗、术后血压波动≥30mmHg是颅内破裂动脉瘤栓塞术后早期破裂再出血的独立危险因素（P〈0．05）。结论年龄／〉50岁、高血压病史、破裂次数≥2次、合并脑血管痉挛、术后抗凝治疗、术后血压波动≥30mmHg是颅内破裂动脉瘤栓塞术后早期破裂再出血的独立危险因素，对该类人群的危险因素进行必要的干预具有重要意义，可以降低颅内破裂动脉瘤栓塞术后早期破裂再出血的发生率并改善预后。
Objective To investigate the risk factors of early rebleeding after ruptured intracranial aneurysm embolization surgery. Methods Forty-two patients with early postoperative rebleeding after ruptured intracranial aneurysm embolization surgery （study group） were enrolled, and 40 patients without early postoperative rebleeding after ruptured intracranial aneurysm embolization surgery at the same period was selected randomly as control group. Single factor and multiple factors were analyzed by non-condition Logistic regression model. Results The single factor analysis result showed that age ≥50,history of hypertension,diabetes history,ruptured frequency number ≥ 2, combined with vasospasm,postoperative anticoagulation therapy,postoperative blood pressure fluctuation ≥30 mm Hg （1 mm Hg = 0.133 kPa）, pseudoaneurysm, fatal embolism and most embolism in study group [ 81.0% （34/42）, 76.2% （32/42）, 66.7% （ 28/42 ）, 76.2% （ 32/42 ）, 81.0% （ 34/42 ）, 76.2% （ 32/42 ）, 66.7% （ 28/42 ）, 66.7% （ 2a/42 ）, 66.7% （28/42） ] had statistical differences compared with those in control group [ 57.5% （23/40）, 50.0% （20/40）, 37.5% （ 15/40）, 50.0% （20/40） ,57.5% （23/40）, 47.5% （ 19/40）, 37.5% （ 15/40）, 37.5% （ 15/40）, 37.5% （15/40） ] （P 〈0.05）. Further multiple factors analysis showed that age ≥50,history of hypertension,ruptured frequency number≥2, combined with vasospasm, postoperative anticoagulation therapy, postoperative bloocl pressure fluctuation≥30 mm Hg were the independent risk factors of early postoperative rebleeding after ruptured intracranial aneurysm embolization surgery （P 〈0.05）. Conclusions Age ≥50,history of hypertension,ruptured frequency number ≥2,combined with vasospasm,postoperative anticoagulation therapy,postoperative blood pressure fluctuation ≥30 mm Hg are the independent risk factors of early postoperative rebleeding after ruptured intracranial aneurysm embolization surgery. The necessary interventions t
出处
《中国医师进修杂志》
2012年第20期10-12,共3页
Chinese Journal of Postgraduates of Medicine
关键词
颅内动脉瘤
动脉瘤
破裂
栓塞
治疗性
Intracranial aneurysm
Aneurysm,ruptured
Embolization,therapeutic
