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Microsurgical Treatment of 86 Anterior Choroidal Artery Aneurysms: Analysis of Factors Influencing the Prognosis.

86 例脉络膜前动脉瘤的显微手术治疗: 影响预后的因素分析。

  • 影响因子:1.04
  • DOI:10.1055/s-0039-3400952
  • 作者列表:"Lu C","Feng Y","Li H","Li S","Gu L","Liu W","Zhang P","Zhang H","Lu D
  • 发表时间:2020-06-19
Abstract

PURPOSE: To explore factors affecting the prognosis of choroidal anterior artery aneurysm (AChAA) and provide a reference for improving the postoperative outcome. METHODS: The clinical data of 86 patients with AChAA who underwent treatment by a single surgeon were collected and analyzed retrospectively. Univariate analysis and multivariate logistic regression analysis were conducted to examine 12 factors that possibly affected outcome. RESULTS: The five factors that affected the patient outcomes were times of subarachnoid hemorrhage (SAH), characteristics of SAH on computed tomography (CT), Hunt-Hess grade, aneurysm size, and presence or absence of postoperative complications. Characteristics of SAH on CT (odds ratio [OR]: 3.727; p = 0.000; 95% confidence interval [CI], 1.850-7.508), aneurysm size (OR: 6.335; p = 0.000; 95% CI, 2.564-15.647), and presence or absence of postoperative complications (OR: 4.141; p = 0.000; 95% CI, 1.995-8.599) were independent risk factors influencing the prognosis. In addition, the incidence of postoperative ischemia (caused by anterior choroidal artery syndrome) is related to the aneurysm emitting part and presence or absence of intraoperative rupture. CONCLUSIONS: The analysis of characteristics of SAH on CT, aneurysm size, and presence or absence of postoperative complications can roughly determine the outcome of patients with AChAAs.

摘要

目的:  探讨脉络膜前动脉瘤 (AChAA) 预后的影响因素,为改善术后预后提供参考。 方法: 对 86 例 AChAA 患者的临床资料进行回顾性分析。进行单因素分析和多因素 logistic 回归分析,检查可能影响结局的 12 个因素。 结果: 影响患者预后的 5 个因素分别为蛛网膜下腔出血 (SAH) 次数、 SAH CT 特征、 Hunt-Hess 分级、动脉瘤大小、以及有无术后并发症。SAH 的 CT 特征 (比值比 [OR]: 3.727; P = 0.000; 95% 可信区间 [CI],1.850-7.508) 、动脉瘤大小 (OR: 6.335; P = 0.000; 95% CI,2.564-15.647) 和有无术后并发症 (or: 4.141; P = 0.000; 95% CI,1.995-8.599)是影响预后的独立危险因素。此外,术后缺血 (由脉络膜前动脉综合征引起) 的发生率与动脉瘤发射部和术中有无破裂有关。 结论: 分析 SAH 的 CT 特征、动脉瘤大小、有无术后并发症可粗略判断 AChAAs 患者的预后。

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