發(fā)布時(shí)間：2018-06-17 10:42

  本文選題：前循環(huán)破裂動(dòng)脈瘤 + 早期顯微手術(shù)�。� 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:分析前循環(huán)破裂動(dòng)脈瘤早期顯微手術(shù)的療效,探討影響前循環(huán)破裂動(dòng)脈瘤患者早期顯微手術(shù)預(yù)后的相關(guān)因素。方法:回顧性分析山西醫(yī)科大學(xué)第一醫(yī)院神經(jīng)外科2014~2016年收治的89例早期顯微手術(shù)治療的前循環(huán)破裂動(dòng)脈瘤患者病例資料,根據(jù)GOS評(píng)分評(píng)價(jià)患者預(yù)后,并利用SPSS19.0統(tǒng)計(jì)學(xué)軟件對(duì)年齡、性別、高血壓、糖尿病、術(shù)前Hunt-Hess分級(jí)、改良Fisher分級(jí)、術(shù)前再出血、動(dòng)脈瘤大小、瘤頸寬度、術(shù)中動(dòng)脈瘤破裂、臨時(shí)阻斷、遲發(fā)性腦缺血、肺部感染、顱內(nèi)感染、術(shù)后腦脊液循環(huán)障礙及遲發(fā)出血等16項(xiàng)可能影響患者預(yù)后的相關(guān)因素進(jìn)行分析,其中單因素分析采用c2檢驗(yàn),而多因素分析則采用Logistic回歸分析。結(jié)果:早期顯微手術(shù)治療的89例前循環(huán)破裂動(dòng)脈瘤患者中,58例預(yù)后良好(65.2%),31例預(yù)后不良(34.8%);單因素分析顯示年齡、高血壓、瘤頸寬度、術(shù)前Hunt-Hess分級(jí)、改良Fisher分級(jí)、遲發(fā)性腦缺血、肺部感染及術(shù)后腦脊液循環(huán)障礙與患者預(yù)后相關(guān)(P0.05);多因素Logistic回歸分析顯示術(shù)前Hunt-Hess分級(jí)(OR=8.994,P=0.048)、遲發(fā)性腦缺血(OR=7.586,P=0.027)及肺部感染(OR=8.323,P=0.004)是影響前循環(huán)破裂動(dòng)脈瘤患者早期顯微手術(shù)預(yù)后的危險(xiǎn)因素。結(jié)論:早期顯微手術(shù)是治療前循環(huán)破裂動(dòng)脈瘤的有效手段,術(shù)前Hunt-Hess分級(jí)、遲發(fā)性腦缺血及肺部感染是影響前循環(huán)破裂動(dòng)脈瘤患者早期顯微手術(shù)預(yù)后的危險(xiǎn)因素。
[Abstract]:Objective: to analyze the effect of early microsurgery on ruptured anterior circulation aneurysms and to explore the factors influencing the prognosis of patients with ruptured anterior circulation aneurysms. Methods: the data of 89 patients with ruptured anterior circulatory aneurysms treated by early microsurgery from 2014-2016 in the first Hospital of Shanxi Medical University were retrospectively analyzed. The prognosis of the patients was evaluated according to the GOS score. Age, sex, hypertension, diabetes, preoperative Hunt-Hess grade, modified Fisher grade, preoperative rebleeding, aneurysm size, width of aneurysm, rupture of aneurysm during operation, temporary occlusion, delayed cerebral ischemia were analyzed by SPSS 19.0 software. Sixteen related factors, such as pulmonary infection, intracranial infection, cerebrospinal fluid circulation disorder and delayed hemorrhage, were analyzed. The univariate analysis was carried out by c2 test, and the multivariate analysis by Logistic regression analysis. Results: among 89 patients with ruptured anterior circulation aneurysm treated by early microsurgery, 58 cases had a good prognosis (65.2%) and 31 cases had poor prognosis (34.8%). Univariate analysis showed age, hypertension, neck width, Hunt-Hess grade before operation, modified Fisher grade, delayed cerebral ischemia. Multivariate logistic regression analysis showed that preoperative Hunt-Hess grade ORT 8.994 P0.048, delayed cerebral ischemia 7.586 P0.027) and pulmonary infection OR8.323P0.004 were associated with early microsurgery in patients with ruptured anterior circulatory aneurysms (P0.05), and multivariate logistic regression analysis (logistic regression analysis) showed that preoperative Hunt-Hess grade and delayed cerebral ischemia were associated with early microsurgery in patients with ruptured aneurysms of the anterior circulation. Risk factors for prognosis. Conclusion: early microsurgery is an effective method for the treatment of ruptured anterior circulation aneurysms. Preoperative Hunt-Hess grade, delayed cerebral ischemia and pulmonary infection are the risk factors for the prognosis of patients with ruptured anterior circulation aneurysms.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R651.12

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 龍連圣;王聰;辛志成;李夏良;蔣超超;蘇強(qiáng);吳鐘華;王偉;章元;胡夷;施順孝;范順志;;早期開(kāi)顱手術(shù)治療高級(jí)別顱內(nèi)前循環(huán)動(dòng)脈瘤[J];生物醫(yī)學(xué)工程與臨床;2017年01期

2 陳旭;詹健;張永安;;顱內(nèi)前循環(huán)動(dòng)脈瘤破裂的手術(shù)時(shí)機(jī)探討[J];基層醫(yī)學(xué)論壇;2016年36期

3 曹紅磊;曹紅巖;;前循環(huán)破裂動(dòng)脈瘤早期顯微手術(shù)療效分析[J];中外醫(yī)療;2016年04期

4 吳鵬昌;蘇永永;白凱;謝江濤;王世峰;向毅;武興興;郭慶東;;翼點(diǎn)入路夾閉前循環(huán)高級(jí)別破裂動(dòng)脈瘤的臨床分析[J];中華神經(jīng)外科疾病研究雜志;2015年06期

5 姚慶東;;血管外顯微手術(shù)及血管內(nèi)介入栓塞治療顱內(nèi)前循環(huán)破裂動(dòng)脈瘤的療效與并發(fā)癥分析[J];中國(guó)社區(qū)醫(yī)師;2015年23期

6 朱家球;陳震;陳慧珍;梁徑山;顏士衛(wèi);孫勇;李?lèi)?ài)民;;顱內(nèi)前循環(huán)動(dòng)脈瘤破裂后手術(shù)時(shí)機(jī)分析[J];實(shí)用醫(yī)學(xué)雜志;2015年03期

7 劉杰;龐恒元;苑菲;王建交;周鳳剛;;顱內(nèi)動(dòng)脈瘤開(kāi)顱術(shù)后患者肺部感染的危險(xiǎn)因素分析[J];現(xiàn)代生物醫(yī)學(xué)進(jìn)展;2015年03期

8 林愛(ài)龍;陳映紅;程新富;羅曉明;錢(qián)晟;劉寧;張志強(qiáng);;經(jīng)翼點(diǎn)入路早期顯微手術(shù)夾閉前循環(huán)動(dòng)脈瘤的臨床研究[J];中華神經(jīng)外科疾病研究雜志;2014年05期

9 簡(jiǎn)國(guó)慶;;血管外顯微手術(shù)及血管內(nèi)介入栓塞治療顱內(nèi)前循環(huán)破裂動(dòng)脈瘤的療效與并發(fā)癥分析[J];中國(guó)實(shí)用神經(jīng)疾病雜志;2014年03期

10 王明海;黃武;龔堅(jiān);楊勁松;吳臣義;劉芳;;顯微手術(shù)治療顱內(nèi)前循環(huán)動(dòng)脈瘤療效及并發(fā)癥分析[J];中華神經(jīng)醫(yī)學(xué)雜志;2012年12期

，

本文編號(hào)：2030757