【摘要】 目的 分析支架辅助弹簧圈栓塞治疗急性期颅内破裂动脉瘤患者发生出血、缺血相关并发症的危险因素。方法 以支架辅助弹簧圈栓塞治疗的50例急性期颅内破裂动脉瘤患者为研究对象。收集患者的一般资料；观察并记录出血、缺血并发症发生情况；分析影响急性期颅内破裂动脉瘤患者发生出血、缺血相关并发症的危险因素。结果 50例急性期颅内破裂动脉瘤患者中，有7例出现出血相关并发症，12例出现缺血相关并发症，并发症总发生率为38.00%。单因素分析结果显示，有出血相关并发症患者的术前Hunt-Hess分级Ⅳ～Ⅴ级、动脉瘤直径<3 mm、前交通动脉瘤占比高于无出血相关并发症患者（P<0.05）；有缺血相关并发症患者的术前Hunt-Hess分级Ⅳ～Ⅴ级、动脉瘤直径11～25 mm、大脑中动脉瘤占比高于无缺血相关并发症患者（P<0.05）。多因素Logistic回归分析结果显示，术前Hunt-Hess分级Ⅳ～Ⅴ级、动脉瘤直径<3 mm、前交通动脉瘤是患者发生出血相关并发症的独立危险因素（P<0.05）；术前Hunt-Hess分级Ⅳ～Ⅴ级、动脉瘤直径11～25 mm、大脑中动脉瘤是患者发生缺血相关并发症的独立危险因素（P<0.05）。结论 应加强急性期颅内破裂动脉瘤患者接受支架辅助弹簧圈栓塞治疗的围手术期相关危险因素的分析，并给予相应的干预措施，以促进患者预后的改善。更多还原

【Abstract】 Objective To analyze the risk factors of bleeding and ischemia-related complications in patients with acute ruptured intracranial aneurysms treated with stent-assisted coil embolization. Methods Fifty patients with acute ruptured intracranial aneurysms treated with stent-assisted coil embolization were selected as the study objects. The general data of patients was collected; the occurrence of bleeding and ischemia-related complications was observed and recorded; the risk factors of bleeding and ischemia related complications in patients with acute ruptured intracranial aneurysms were analyzed. Results Among the 50 patients with acute ruptured intracranial aneurysms, 7 cases had bleeding-related complications, 12 cases had ischemia-related complications, and the total incidence of complications was 38.00%. The results of univariate analysis showed that the proportions of preoperative Hunt-Hess grade Ⅳ-Ⅴ, aneurysm diameter < 3 mm and anterior communicating aneurysm in patients with bleeding-related complications were higher than those in patients without bleeding-related complications(P<0.05); the proportions of preoperative Hunt-Hess grade Ⅳ-Ⅴ, aneurysm diameter11-25 mm and middle cerebral aneurysm in patients with ischemic-related complications were higher than those in patients without ischemic-related complications(P <0.05). Logistic multivariate analysis results showed that preoperative Hunt-Hess grade Ⅳ-Ⅴ, aneurysm diameter < 3 mm and anterior communicating artery aneurysm were independent risk factors for bleedingrelated complications(P<0.05); preoperative Hunt-Hess grade Ⅳ-Ⅴ, aneurysm diameter 11-25 mm and middle cerebral artery aneurysm were independent risk factors for ischemia-related complications(P<0.05). Conclusion The analysis of perioperative risk factors in patients with acute ruptured intracranial aneurysms undergoing stent-assisted coil embolization should be strengthened, and corresponding interventions should be given to promote the improvement of prognosis.更多还原