[1]赵喜鹏　张云峰.颅内破裂动脉瘤血管内栓塞术后发生神经系统并发症的危险因素[J].中国临床神经外科杂志,2020,(01):19-21.[doi:10.13798/j.issn.1009-153X.2020.01.007]
　ZHAO Xi Peng,ZHANG Yun-feng..Analysis of factors related to neurological complications after interventional therapy in patients with ruptured intracranial aneurysms[J].,2020,(01):19-21.[doi:10.13798/j.issn.1009-153X.2020.01.007]
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颅内破裂动脉瘤血管内栓塞术后发生神经系统并发症的危险因素()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年01期
页码:
19-21
栏目:
论著
出版日期:
2020-01-25

文章信息/Info

Title:
Analysis of factors related to neurological complications after interventional therapy in patients with ruptured intracranial aneurysms
文章编号:
1009-153X（2020）01-0019-03
作者:
赵喜鹏　张云峰
246000 安徽安庆，中国人民解放军海军安庆医院神经外科（赵喜鹏、张云峰）
Author(s):
ZHAO Xi Peng;  ZHANG Yun-feng.
Department of Neurosurgery, Anqing Hospital, Navy, Chinese People's Liberation Army, Anqing 246000, China
关键词:
颅内破裂动脉瘤; 血管内栓塞; 神经系统并发症; 危险因素
Keywords:
Ruptured intracranial aneurysms;  Interventional therapy;  Neurological complications;  Risk factors
分类号:
R 743.9; R 815.2
DOI:
10.13798/j.issn.1009-153X.2020.01.007
文献标志码:
A
摘要:
目的 探讨颅内破裂动脉瘤血管内栓塞治疗后并发神经系统并发症的危险因素。方法 回顾性分析2015年5月至2018年5月血管内栓塞治疗的190例颅内破裂动脉瘤的临床资料。采用多因素logistic回归分析检验危险因素。结果 术后随访3个月，发生神经系统并发症21例，发生率为11.1%，其中其中血栓栓塞12例，术后早期再破裂出血4例，术中动脉瘤破裂3例，术后早期硬膜下出血或远隔部位脑实质出血2例。多因素logistic回归分析显示，合并高血压、Fisher分级Ⅲ~Ⅳ级、Hunt-Hess分级Ⅳ~Ⅴ级、宽颈动脉瘤、动脉瘤有小阜是颅内破裂动脉瘤血管内栓塞术后发生神经系统并发症发生的独立危险因素（P<0.05）。结论 颅内破裂动脉瘤血管内栓塞术后神经系统并发症发生率较高，临床应对存在高危因素的病人提前做好术前预案，以减少术后并发症。
Abstract:
Objective To investigate the risk factors of neurological complications after the interventional therapy of ruptured intracranial aneurysms (RIAs) and their prevention methods. Methods Of 190 patients with RIAs treated by interventional method in our hospital from May, 2015 to May, 2018, 21 suffered from postoperative neurological complications and 169 did not within 3 months after the interventional therapy. The Risk factors related to the neurological complications after intervention therapy of RIAs were analyzed. Results Twenty-one patients with postoperative neurological complications accounted for 11.05% 0f the patients with RIAs receiving intentional therapy at the same period. Logistic regression analysis showed that hypertension history, Fisher grades Ⅲ~Ⅳ, Hunt-Hess grades Ⅳ~Ⅴ, wide-neck aneurysms, and caruncles were independent risk factors related to the neurological complications after the interventional therapy in the patients with RIAs (P<0.05). Conclusions There is a high rate of occurrence of neurological complications in the patients with RIAs after the interventional therapy. The present results suggest that the independent risk factors related to the postoperative neurological complications include the history of hypertension, Fisher grades Ⅲ-Ⅳ, Hunt-Hess grades Ⅳ~Ⅴ, wide-neck aneurysms and caruncles in the patients with RIAs.

参考文献/References:

[1] Sluzewski M, van Rooij WJ, Beute GN, et al. Late rebleeding of ruptured intracranial aneurysms treated with detachable coils [J]. Am J Neuroradiol, 2016, 26(10): 2542-2549.
[2] 何婉玲，袁惠萍，罗　鹏. 川芎嗪在颅内动脉瘤介入围手 术期脑血管痉挛预防的临床效果观察[J]. 世界中西医结 合杂志，2017，12（4）：524-526.
[3] Korkmaz E, Kleinloog R, Verweij BH, et al. Comparative ultrastructural and stereological analyses of unruptured and ruptured saccular intracranial aneurysms [J]. J Neuropathol Exp Neurol, 2017, 76(10): 908-913.
[4] Korja M, Kivisaari R, Rezai JB, et al. Natural history of ruptured but untreated intracranial aneurysms [J]. Stroke, 2017, 48(4): 1081-1088.
[5] 郑云贵，卢晓闻，许烈鹏，等. 颅内破裂微小动脉瘤预后的 影响因素分析[J]. 中国临床神经外科杂志，2017，12（9）： 634-635.
[6] Rivero DR, Scherle CM, Fernández LC, et al. Factors asso- ciated with poor outcome for aneurysmal subarachnoid hae- morrhage in a series of 334 patients [J]. Neurologia, 2015, 53(14): 269-273.
[7] Yang P, Zhao K, Zhou Y, et al. Stent-assisted coil placement for the treatment of 211 acutely ruptured wide-necked intracranial aneurysms: a single-center 11-year experience [J]. Radiology, 2015, 276(2): 545-552.
[8] Bian LH, Liu YF, Nichols LT, et al. Epidemiology of sub- arachnoid hemorrhage, patterns of management, and out- comes in China: a hospital-based multicenter prospective study [J]. CNS Neurosci Therapeut, 2012, 18(11): 895-902.
[9] Duan G, Lv N, Yin J, et al. Morphological and hemodynamic analysis of posterior communicating artery aneurysms prone to rupture: a matched case-control study [J]. J Neurointer- vent Surg, 2014, 130(5): 693-706.
[10] Yu JL, Wang HL, Xu K, et al. Endovascular treatment of an intracranial aneurysm with a ruptured bleb [J]. Neuroscien- ces, 2012, 17(2): 127-132.

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备注/Memo

备注/Memo:
（2019-01-24收稿，2019-04-19修回）
更新日期/Last Update: 2020-01-25