[1]幸 标 彭占威 李 俊.前交通动脉动脉瘤夹闭术后并发中枢性尿崩症的危险因素[J].中国临床神经外科杂志,2019,(10):586-588.[doi:10.13798/j.issn.1009-153X.2019.10.003]
 XING Biao,PENG Zhan-wei,LI Jun..Analysis of factors related to central diabetes insipidus after clipping of anterior communicating artery aneurysms[J].,2019,(10):586-588.[doi:10.13798/j.issn.1009-153X.2019.10.003]
点击复制

前交通动脉动脉瘤夹闭术后并发中枢性尿崩症的危险因素()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年10期
页码:
586-588
栏目:
论著
出版日期:
2019-10-20

文章信息/Info

Title:
Analysis of factors related to central diabetes insipidus after clipping of anterior communicating artery aneurysms
文章编号:
1009-153X(2019)10-0586-03
作者:
幸 标 彭占威 李 俊
430010 武汉,华中科技大学同济医学院附属武汉市中心医院神经外科(幸 标、彭占威、李 俊)
Author(s):
XING Biao PENG Zhan-wei LI Jun.
Department of Neurosurgery, Wuhan Municipal Central Hospital Affiliated to Tongji Medical school, Huazhong University of Sciences and Technology, Wuhan 430010, China
关键词:
前交通动脉动脉瘤显微夹闭术中枢性尿崩症危险因素
Keywords:
Anterior communicating artery Intracranial aneurysms Craniotomy Central diabetes insipidus Risk factor
分类号:
R 743.9; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2019.10.003
文献标志码:
A
摘要:
目的 探讨前交通动脉动脉瘤夹闭术后并发中枢性尿崩症(CDI)的危险因素。方法 回顾性分析2009年1月~2018年1月显微夹闭术治疗的154例前交通动脉动脉瘤的临床资料;采用多因素logistic回归分析法筛选术后并发CDI的危险因素。结果 154例中,术后并发CDI 13例(8.4%)。多因素 logistic 回归分析结果显示术中动脉瘤破裂是术后并发CDI的独立危险因素(OR=15.642;95% CI 1.035~236.447;P=0.047]。结论 前交通动脉动脉瘤夹闭术中,如果发生动脉瘤破裂,临床应注意防治CDI。
Abstract:
Objective To investigate the factors related to the central diabetes insipidus (CDI) after clipping of anterior communicating artery (ACoA) aneurysms. Methods The clinical data of 154 patients with ACoA aneurysms undergoing craniotomy in our hospital from January, 2009 to January, 2018 were analyzed retrospectively. Of these 154 patients, 13 had CDI and 141 not after the craniotomy. The factors related to CDI were statistically analyzed. Results The univariate analysis showed that the factors related to the postoprative CDI included the preoperative Hunt-Hess grade, aneurismal form, intraoperative aneurysms rupture, new cerebral infarct, operative injury to the penetrating blood vessel and time of temporary occlusion of the parent artery. The multivariate logistic regression analysis showed that the rupture of aneurysm during the operation was the independent risk factor of CDI after the clipping of ACoA aneurysms (OR=15.642, 95% CI: 1.035~236.447, P<0.05). Conclusion The intraoperative rupture of aneurysms strongly suggests that CDI may occur after the craniotomy in the patients with ACoA aneurysms.

参考文献/References:

[1] 王 潞,李 俊,陈 文,等. 显微手术治疗前交通动脉动 脉瘤(附115例报道)[J]. 中国临床神经外科杂志,2017, 22(5):299-301. [2] 黄进兴,叶 敏,李劲松,等. 显微手术治疗前交通动脉动 脉瘤33例[J]. 中国临床神经外科杂志,2017,22(7):489- 490. [3] 武 高,桂 卉,张 力. 前交通动脉复合体的显微解剖 研究[J]. 中国临床神经外科杂志,2017,22(2):92-94. [4] Sayama T, Inamura T, Matsushima T, et al. High incidence of hyponatremia in patients with ruptured anterior commu- nicating artery aneurysms [J]. Neurol Res, 2000, 22(2): 151-155. [5] 刘 伟,刘显明, 张继方,等. 前交通动脉瘤术后并发中 枢性尿崩症原因分析[J]. 中华神经外科疾病研究杂志, 2011,10(1):67-68. [6] 杨帮国,洪 涛,魏入廷,等. 前交通动脉动脉瘤预后的影 响因素分析[J]. 中国临床神经外科杂志,2018,23(5): 315-317. [7] Arima H, Azuma Y, Morishita Y, et al. Central diabetes insipidus [J]. Nagoya J Med Sci, 2016, 78(4): 349-358. [8] 张吉平,郭清华,母义明,等. 230例中枢性尿崩症患者病 因分布及临床特点分析[J]. 中华内科杂志,2018,57(3): 201-205. [9] McIver B, Connacher A, Whittle I, et al. Adipsic hypotha- lamic diabetes insipidus after clipping of anterior commu- nicating artery aneurysm [J]. BMJ, 1991, 303(6815): 1465- 1467. [10] 张俊功,聂秀涛,胡庆雷,等. 破裂前交通动脉动脉瘤夹闭 术中动脉瘤再次破裂病人预后不良的危险因素[J]. 中国 临床神经外科杂志,2019,24(4):236-237. [11] Bohnstedt BN, Conger AR, Edwards J, et al. Anterior com- municating artery complex aneurysms: anatomic characte- ristics as predictors of surgical outcome in 300 cases [J]. World Neurosurg, 2019, 122: e896-e906. [12] Nossek E, Setton A, Karimi R, et al. Analysis of superiorly projecting anterior communicating artery aneurysms: anatomy, techniques, and outcome. a proposed classification system [J]. Neurosurg Rev, 2016, 39(2): 225-235. [13] Yamamoto Y, Fukuda H, Yamada D, et al. Association of perforator infarction with clinical courses and outcomes following surgical clipping of ruptured anterior communica- ting artery aneurysms [J]. World Neurosurg, 2017, 107: 724-731.

相似文献/References:

[1]冯 力 李中林 纪培志.经大脑前纵裂入路手术夹闭前交通动脉动脉瘤18例[J].中国临床神经外科杂志,2015,(12):746.[doi:10.13798/j.issn.1009-153X.2015.12.014]
[2]张 扬 余 舰 晁迎九 魏建军 高 歌 陈 昱 顾大群.支架辅助弹簧圈栓塞治疗宽颈前交通动脉动脉瘤的临床分析[J].中国临床神经外科杂志,2015,(08):473.[doi:10.13798/j.issn.1009-153X.2015.08.009]
 ZHANG Yang,YU Jian,CHAO Ying-jiu,et al.Stent-assisted coils embolization of wide-necked anterior communicating artery aneurysms (report of 35 cases)[J].,2015,(10):473.[doi:10.13798/j.issn.1009-153X.2015.08.009]
[3]张显强 刘胜初 杨建雄 廖驭国 罗 捷 杨 华.前交通动脉动脉瘤70例治疗分析[J].中国临床神经外科杂志,2015,(07):422.[doi:10.13798/j.issn.1009-153X.2015.07.013]
[4]殷尚炯 刘洪泉 王洪生 杜秀玉.前交通动脉动脉瘤的显微手术治疗[J].中国临床神经外科杂志,2015,(09):529.[doi:10.13798/j.issn.1009-153X.2015.09.006]
 YIN Shang-jiong,LIU Hong-quan,WANG Hong-sheng,et al.Microsurgical management of anterior communicating artery aneurysms[J].,2015,(10):529.[doi:10.13798/j.issn.1009-153X.2015.09.006]
[5]袁 欣 窦娴丽 孙 璐 王秋寒 丰育功.前交通动脉动脉瘤夹闭术围手术期的护理[J].中国临床神经外科杂志,2015,(05):301.[doi:10.13798/j.issn.1009-153X.2015.05.016]
[6]王华松 纵 习 李宗正.微血管多普勒超声监测在前交通动脉动脉瘤夹闭术中的应用[J].中国临床神经外科杂志,2016,(08):473.[doi:10.13798/j.issn.1009-153X.2016.08.010]
 WANG Hua-song,ZONG Xi,LI Zong-zheng..Application of intraoperative microvascular Doppler ultrasonography monitoring in clipping anterior communicating areary neurysms[J].,2016,(10):473.[doi:10.13798/j.issn.1009-153X.2016.08.010]
[7]胡 骁 周林裕 殷汉荣 杨艳如 代永庆.Lvis支架辅助弹簧圈栓塞破裂宽颈前交通动脉动脉瘤的疗效分析[J].中国临床神经外科杂志,2017,(05):325.[doi:10.13798/j.issn.1009-153X.2017.05.014]
[8]黄进兴,叶敏,李劲松,等.显微手术治疗前交通动脉动脉瘤33例[J].中国临床神经外科杂志,2017,(07):489.[doi:10.13798/j.issn.1009-153X.2017.07.014]
[9]杨建龙 胡 焱 徐东为 闫忠军.前交通动脉动脉瘤发生的相关危险因素分析[J].中国临床神经外科杂志,2017,(09):636.[doi:10.13792017.09/j.issn.1009-153X.2017.09.009]
 ANG Jian-long,HU Yan,XU Dong-wei,et al.Analysis of risk factors related to pathogenesis of anterior communicating aneurysm[J].,2017,(10):636.[doi:10.13792017.09/j.issn.1009-153X.2017.09.009]
[10]晁迎九、陈 昱、高 歌、张 扬、牛朝诗、魏祥品.颅咽管瘤伴前交通动脉动脉瘤1例[J].中国临床神经外科杂志,2017,(09):672.[doi:10.13792017.09/j.issn.1009-153X.2017.09.023]

备注/Memo

备注/Memo:
基金项目:武汉市卫生局临床医学科研项目(WX12B02);武汉市临床医学研究中心项目;通讯作者:李 俊,E-mail:lj690222@sina.com(2019-02-26收稿,2019-07-01修回)
更新日期/Last Update: 2019-10-20