【摘要】：目的:探討已破裂前循環(huán)動(dòng)脈瘤外科手術(shù)夾閉治療預(yù)后的相關(guān)因素。資料與方法:回顧性分析61例經(jīng)外科手術(shù)夾閉治療的已破裂前循環(huán)動(dòng)脈瘤患者的病歷資料,包括患者的年齡、出血次數(shù)、Hunt-Hess評(píng)分、Fisher評(píng)分等。患者出院后6個(gè)月的預(yù)后情況采用改良的Rankin量表評(píng)分(mRS)作為評(píng)分標(biāo)準(zhǔn)。先對(duì)可能影響預(yù)后的因素進(jìn)行單因素分析,再將單因素分析有統(tǒng)計(jì)學(xué)意義的因素納入多因素Logistic回歸進(jìn)行分析。結(jié)果:單因素分析提示出血次數(shù)、Hunt-Hess評(píng)分、GCS評(píng)分、Fisher評(píng)分、術(shù)后有無(wú)腦血管并發(fā)癥、術(shù)后有無(wú)顱內(nèi)感染與預(yù)后相關(guān)(P0.05),多因素分析提示Hunt-Hess評(píng)分(OR=40.243)、Fisher評(píng)分(OR=12.820)、術(shù)后腦血管并發(fā)癥(OR=39.469)是影響已破裂前循環(huán)動(dòng)脈瘤預(yù)后的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論:Hunt-Hess評(píng)分、Fisher評(píng)分、術(shù)后有無(wú)腦血管并發(fā)癥是顯著影響已破裂前循環(huán)動(dòng)脈瘤外科手術(shù)夾閉治療患者預(yù)后的因素,重視這些因素的預(yù)測(cè)價(jià)值對(duì)降低已破裂前循環(huán)動(dòng)脈瘤患者的病死率和致殘率有重要臨床意義。
[Abstract]:Objective: to investigate the prognostic factors of ruptured anterior circulatory aneurysms after surgical clipping. Materials and methods: the medical records of 61 patients with ruptured anterior circulatory aneurysms, including age, bleeding times, Hunt-Hess score, Fisher score and so on, were analyzed retrospectively. The prognosis of the patients at 6 months after discharge was evaluated by modified Rankin scale score (mRS). The factors that may affect the prognosis were analyzed by univariate analysis, and then the factors with statistical significance were analyzed by multivariate Logistic regression analysis. Results: univariate analysis showed that bleeding frequency, Hunt-Hess score, GCS score, Fisher score, postoperative cerebrovascular complications, postoperative intracranial infection and prognosis were related to the prognosis (P0.05), multivariate analysis suggested Hunt-Hess score (OR=40.243). Fisher score (OR=12.820) and postoperative cerebrovascular complications (OR=39.469) were independent risk factors for prognosis of ruptured anterior circulatory aneurysms (P0.05). Conclusion: Hunt-Hess score, Fisher score, postoperative cerebrovascular complications are the significant factors that affect the prognosis of patients with ruptured anterior circulation aneurysm after surgical clipping. Paying attention to the predictive value of these factors is of great clinical significance in reducing the mortality and disability rate of patients with ruptured anterior circulatory aneurysms.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R651.12

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