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颅内破裂动脉瘤介入术中再破裂的危险因素分析 被引量:5

Analysis of rupture of intracranial rupture aneurysm during intervention
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摘要 目的 探讨颅内破裂动脉瘤介入术中再破裂的可能原因。方法选择2015年1月至2016年10月在本院进行颅内破裂动脉瘤介入治疗的患者261例,其中14例术中发生动脉瘤再破裂,分析患者的住院病历和手术记录,总结颅内破裂动脉瘤介入治疗过程中再破裂的危险因素并探讨防护策略。结果可能导致颅内破裂动脉瘤介入治疗过程中再破裂的危险因素包括高血压病史、动脉瘤大小(微小动脉瘤)、动脉瘤部位(前交通动脉瘤)、动脉瘤形状(有不规则分叶或有凸起)及术中载瘤动脉痉挛(P<0.05),而患者性别、年龄、Hunt-Hess分级等因素与介入术中再破裂无明显关系(P>0.05)。结论颅内破裂动脉瘤介入治疗前应充分考虑可能导致术中再破裂的危险因素,并提前制定应对策略;术中发生再破裂后积极进行急救处理有利于有效控制病情、减少并发症的发生及改善患者预后。 Objective To investigate the causes of recanalysis during the interventional treatment of intracranial ruptured aneurysms.Method From January 2015 to October 2016, 261 cases of cerebral aneurysm interventional therapy were performed in our hospital.Among them, 14 cases of recurrent rupture occurred during operation. By analyzing the inpatient records and surgical records of patients,the conclusion may lead to intracranial interventional therapy. Rupture of aneurysm during rupture of the various factors and to explore protective strategies. Result The factors may lead to endovascular interventional treatment of intracranial ruptured aneurysm frequent rupture included history of hypertension, aneurysm size(small aneurysm), aneurysm site(anterior communicating artery aneurysm),aneurysm shape(with irregular points(P〈0.05). However, the intracranial rupture of intracranial rupture aneurysm was not related to the gender, age, Hunt-Hess classification and other factors(P〉0.05). Conclusion For the patients with intracranial rupture aneurysm, adjuvant therapy should be given before operation,and the risk factors of possible rupture should be fully considered before operation and the coping strategy should be worked out in advance. After the intraoperative rupture of the aneurysm, the emergency treatment is taken actively to control the disease and reduce the complication The occurrence of patients with improved prognosis.
作者 瓮杰慧 王维 刘新静 何文英 WENG Jie-hui;WANG Wei;LIU Xin-jing;HE Wen-ying(Department of Neurosurgery, Second Hospital of Hebei Medical University, Hebei Shijiazhuang 050000, Chin)
出处 《中国医刊》 CAS 2018年第4期401-404,共4页 Chinese Journal of Medicine
基金 河北省2014年度医学科学研究重点课题(ZL20140170)
关键词 颅内动脉瘤 血管内介入治疗 破裂动脉瘤术中再破裂 Intracranial aneurysms Intravascular interventional therapy Rupture of ruptured aneurysms
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