本文選題：顱內動脈瘤 + 夾閉手術　； 參考：《新鄉(xiāng)醫(yī)學院》2014年碩士論文

【摘要】：背景：患者在顱內動脈瘤破裂后非手術治療一個月之內的死亡率高達50%以上,即便在存活的病人之中仍會遺留有嚴重的神經功能損害,對病人及家屬都帶來了非常大的危害�，F階段國內外研究顱內動脈瘤手術治療預后影響因素主要包括年齡、基礎疾病、術前Hunt-Hess分級、手術時機、動脈瘤特征、動脈瘤術中臨時夾閉以及手術并發(fā)癥等,但具體結果因樣本差異均不一致,且部分因素還無定論。 目的：探討瘤頸夾閉手術治療顱內動脈瘤破裂預后的相關影響因素,以期為改善患者預后提供有力的參考依據。 方法：選擇2010年2月～2013年2月在我院神經外科收治的248例顱內動脈瘤破裂病人作為本次研究對象,并符合納入標準和排除標準。統(tǒng)計病人預后良好的例數,并對可能影響預后的年齡、性別、Hunt-hess分級、動脈瘤特征、手術時機以及高血壓病史等因素進行單因素和多因素分析。 結果：(1)總共納入的248例顱內動脈瘤患者中有199例(80.2%)預后良好,而有49例(19.8%)預后不良。(2)通過單因素分析,Hunt-hess分級、瘤頸寬度、動脈瘤部位、高血壓等因素都對患者預后影響的差異顯著,具有統(tǒng)計學意義(P0.05)；而年齡、性別、瘤體大小、多發(fā)動脈瘤、手術時機等因素都對患者預后影響的差異不顯著,無統(tǒng)計學意義(P0.05)。 結論：(1)Hunt-hess分級(Ⅳ、V級)、瘤頸寬度(≥4mm)、動脈瘤部位(后循環(huán)動脈)、高血壓等是顱內動脈瘤破裂預后的獨立危險性因素。患者Hunt-hess分級高、瘤頸寬,動脈瘤處于后循環(huán)動脈,以及有高血壓病史都使預后變差。(2)患者的年齡、性別、手術時機、動脈瘤大小及其是否多發(fā)等都與患者預后沒有顯著的相關性,不屬于動脈瘤破裂預后的獨立影響因素。
[Abstract]:Background: the death rate of patients with intracranial aneurysm rupture within one month after non-surgical treatment is as high as 50%, even in the survival of patients will still have serious neurological damage, which has brought great harm to patients and their families. At present, the factors influencing the prognosis of intracranial aneurysm surgery at home and abroad include age, underlying diseases, preoperative Hunt-Hess classification, surgical timing, aneurysm characteristics, temporary clipping during aneurysm operation and surgical complications. However, the specific results are not consistent because of sample differences, and some factors are not conclusive. Objective: to investigate the prognostic factors of intracranial aneurysm rupture in the treatment of intracranial aneurysm rupture by clipping operation of aneurysm neck, so as to provide a useful reference for improving the prognosis of patients. Methods: 248 patients with ruptured intracranial aneurysms from Feb 2010 to Feb 2013 in our hospital were selected as the subjects, and the criteria of inclusion and exclusion were met. The number of patients with good prognosis was counted, and univariate and multivariate analysis was carried out on factors such as age, sex Hunt-hess grade, characteristics of aneurysm, timing of operation and history of hypertension. Results among the 248 patients with intracranial aneurysm, 199 had good prognosis, while 49 had poor prognosis.) Hunt-hess grade, neck width and aneurysm location were analyzed by univariate analysis. However, age, sex, tumor size, multiple aneurysms, operative timing and other factors had no significant difference in the prognosis of the patients. Conclusion the Hunt-hess grade (鈪，

本文編號：1979380