在动脉瘤下arachnoid 出血后手术相关的脑梗塞的危险因素
Cheng Yang1, Zenan Zhao2, Yuanwen Zheng3
1Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, 400038, China.
Neurosurgical review
|May 2, 2025
概括
在动脉瘤下关节出血 (aSAH) 后与手术相关的脑梗塞 (SRCI) 在剪切治疗比内血管治疗更常见. 风险因素因治疗而异,包括切割的糖尿病和EVD,以及内血管方法的年龄和高血压.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 血管外科 血管外科
背景情况:
- 与手术相关的脑梗塞 (SRCI) 是动脉瘤下关节出血 (aSAH) 后的一个重大并发症.
- 目前对不同治疗方式的SRCI特征和风险因素的理解仍然不足.
研究的目的:
- 为了分析与SRCI相关的风险因素,在接受剪切或内血管治疗aSAH的患者中.
- 为了比较剪切和内血管治疗组之间的SRCI的发病率和特征.
主要方法:
- 追溯研究包括472名aSAH患者,分为剪切 (169名患者) 和内血管 (303名患者) 组.
- 放射学证实SRCI作为主要结局.
- 使用单变量和多变量统计分析来识别风险因素并总结SRCI特征.
主要成果:
- 剪切组 (47%) 的SRCI发病率明显高于内血管组 (21%).
- 在剪切组中,SRCI与更高的HH和mFisher得分,糖尿病,初级外腔室排水 (EVD),解压性脑膜切除术,多重动脉瘤修复和更长的手术时间有关.
- 在内血管组中,SRCI与年龄较大,高血压,更高的HH分数,更长的手术时间,急性头,3型大动脉门和近邻母动脉狭窄有关.
- 多变量分析确定了糖尿病,初级EVD,更长的手术时间和多重动脉瘤修复作为剪切组中SRCI的独立预测因素.
- 年龄,高血压,3型大动脉门和近接母动脉狭窄被确定为内血管组中SRCI的独立预测因素.
结论:
- 治疗方式在aSAH后显著影响SRCI风险,剪切与更高的发病率相关.
- 不同的独立风险因素集预测了剪切与内血管治疗组中的SRCI,突出了定制预防策略的必要性.
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