动脉瘤破裂出血行血管内介入栓塞术后并发脑梗死临床分析
赖 湘 张文波 叶 敏 谢 锋 刘晓平 罗兴达
梅州市人民医院，广东 梅州 514031
通信作者：赖湘
【摘要】 目的 探讨前交通动脉瘤破裂伴蛛网膜下腔出血行血管内介入栓塞术后并发脑梗死的独立危险因素。方法 回顾性分析 2016-01—2020-04 于梅州市人民医院确诊的前交通动脉瘤破裂伴蛛网膜下腔出血患者 180 例，将其中 37 例行血管内介入栓塞术后再梗死纳入脑梗死组，143 例行血管内介入栓塞术后无脑梗死情况发生纳入非脑梗死组，以单因素分析对血管内介入栓塞术后并发脑梗死的影响因子进行筛选后，采用多因素 Logistic 分析寻求其独立危险因素。结果 单因素分析显示，神经功能障碍、脑积水、血肿、动脉瘤大小、宽颈动脉瘤、卒中史、高血压史、糖尿病史为血管内介入栓塞术后并发脑梗死的影响因子（P<0.05）；多因素 Logistic 回归分析显示，血肿（OR=2.421，P=0.010）、脑积水（OR=3.561，P=0.027）为血管内介入栓塞术后再梗死的独立危险因素。结论 前交通动脉瘤破裂伴蛛网膜下腔出血行血管内介入栓塞术后并发脑梗死的影响因素较多，临床应针对血肿、脑积水等常见危险因素进行预防和干预，可降低介入栓塞术后脑梗死的发生风险。
【关键词】 前交通动脉瘤；蛛网膜下腔出血；脑梗死；血管内介入栓塞术；危险因素
【中图分类号】 R743.35 【文献标识码】 A 【文章编号】 1673-5110 （2022） 06-0746-06
DOI：10.12083/SYSJ.220528
Clinical analysis of cerebral infarction after intravascular interventional embolization for aneurysm rupture with hemorrhage
LAI Xiang，ZHANG Wenbo，YE Min，XIE Feng，LIU Xiaoping，LUO Xingda
Meizhou People’s Hospital，Meizhou 514031，China
Corresponding author：LAI Xiang
【Abstract】 Objective To investigate the independent risk factors of cerebral infarction after intravascular interventional embolization for anterior communicating aneurysm rupture with subarachnoid hemorrhage. Methods Totally 180 patients with anterior communicating aneurysm rupture complicated with subarachnoid hemorrhage diagnosed in Meizhou People’s Hospital were retrospectively analyzed between January 2016 and April 2020. Among them，37 cases with re-infarction after intravascular interventional embolization were included in the cerebral infarction group，and 143 cases without cerebral infarction were enrolled as the non-cerebral infarction group. After screening the influencing factors of cerebral infarction after intravascular interventional embolization by univariate analysis，the independent risk factors were found by multivariate Logistic analysis. Results Univariate analysis showed that neurological dysfunction，hydrocephalus，hematoma，aneurysm size，wide necked aneurysm，stroke history，hypertension history and diabetes history were the influencing factors of cerebral infarction after intravascular interventional embolization （P<0.05）. Multivariate Logistic regression analysis showed that hematoma（OR=2.421，P=0.010）and hydrocephalus（OR=3.561，P=0.027）were independent risk factors for re-infarction after intravascular interventional embolization. Conclusion There are many influencing factors of cerebral infarction after intravascular interventional embolization for anterior communicating artery aneurysm rupture with subarachnoid hemorrhage. It is necessary to carry out prevention and intervention for common risk factors such as hematoma and hydrocephalus in clinical practice so as to reduce the risk of cerebral infarction after interventional embolization.
【Key words】 Anterior communicating aneurysm rupture；Subarachnoid hemorrhage；Cerebral infarction；Intravascular interventional embolization；Risk factors
