【摘要】 目的探讨颅内破裂动脉瘤夹闭术后并发急性缺血性卒中的相关危险因素。方法以2013年1月至2018年1月施行颅内动脉瘤夹闭术辅助脑室外引流术或去骨瓣减压术的颅内破裂动脉瘤患者为观察对象,单因素和多因素后退法Logistic回归分析筛查术后并发急性缺血性卒中的相关危险因素。结果共267例患者中62例(23.22%)颅内动脉瘤夹闭术后并发急性缺血性卒中;单因素与多因素Logistic回归分析一致提示,合并高血压(OR=1.695,95%CI:1.247～2.631;P=0.006)、入院时血糖升高(OR=4.206,95%CI:2.771～6.284;P=0.000)、术前Hunt-Hess分级≥Ⅲ级(OR=1.443,95%CI:1.205～1.872;P=0.017)、合并脑室出血(OR=1.947,95%CI:1.465～2.973;P=0.001)和急性脑积水(OR=3.221,95%CI:2.218～4.960;P=0.000)是颅内动脉瘤夹闭术后并发急性缺血性卒中的危险因素。结论合并高血压、入院时血糖升高、术前Hunt-Hess分级≥Ⅲ级、合并脑室出血和急性脑积水的颅内破裂动脉瘤患者夹闭术后易发生急性缺血性卒中。更多还原

【Abstract】 Objective To analyze risk factors related to acute ischemic stroke after intracranial aneurysm clipping.Methods From January 2013 to January 2018,267 cases of intracranial ruptured aneurysm in our hospital were collected retrospectively.All patients were given intracranial aneurysm clipping,ventricular drainage and decompression with bone flap vemova.Univariate and multivariate backward Logistic regression analysis were used to analyze the risk factors for ischemic stroke after intracranial aneurysm clipping.Results There were 62 patients(23.22%) with acute ischemic stroke after intracranial aneurysm clipping.Logistic regression analysis showed that hypertension(OR=1.695,95%CI:1.247-2.631;P=0.006),blood glucose(OR=4.206,95%CI:2.771-6.284;P=0.000),Hunt-Hess grade≥Ⅲ(OR=1.443,95%CI:1.205-1.872;P=0.017),ventricular hemorrhage(OR=1.947,95%CI:1.465-2.973;P=0.001) and acute hydrocephalus(OR=3.221,95%CI:2.218-4.960;P=0.000) were risk factors for acute ischemic stroke after intracranial aneurysm clipping.Conclusions The hypertension,blood glucose increased on admission,preoperative Hunt-Hess grade ≥Ⅲ,ventricular hemorrhage and acute hydrocephalus were risk factors for acute ischemic stroke after clipping of intracranial aneurysm rupture.更多还原