摘要
目的探讨颅内静脉窦中横窦分型与颅内动脉瘤形成及破裂的临床相关性,并预测颅内动脉瘤破裂可能的新易感因素。方法根据纳入及排除标准,回顾性分析我院2018年1月至12月345例颅内动脉瘤患者,根据是否破裂分两组,即破裂动脉瘤(ruptured aneurysm group,RAG)组(230例)和未破裂动脉瘤(unruptured aneurysm group,URAG)组(115例),分析RAG组和URAG组的静脉窦解剖结构及横窦引流情况,比较两组患者年龄、性别、既往史,动脉瘤的部位、大小、动脉瘤是否破裂及多发性等临床特征,明确颅内动脉瘤破裂发生的易感因素。结果颅内动脉瘤破裂与患者的饮酒史、吸烟史、高血压、糖尿病、动脉瘤部位、大小及动脉瘤同侧的优势横窦有统计学意义(P<0.05);多因素logistic回归分析提示:前交通动脉瘤(OR=2.214)、后交通动脉瘤(OR=2.932)、小动脉瘤(OR=3.841)、与动脉瘤同侧的优势横窦(OR=1.736)为未破裂动脉瘤发生破裂的独立危险因素。此外,横窦优势侧更易形成颅内动脉瘤(P<0.001)。结论颅内动脉瘤破裂的易感因素为前交通动脉瘤、后交通动脉瘤、小动脉瘤及与动脉瘤同侧的优势横窦;合并优势横窦患者的同侧颅内动脉系统更易形成动脉瘤,并可据此特征较准确的预测动脉瘤破裂。
Objective To investigate the clinical correlation between transverse sinus classification and variation and aneurysm formation and rupture and to determine the risk factors of intracranial aneurysm rupture.Methods A retrospective data analysis was conducted on a total of 345 cases of intracranial aneurysms from January to December 2018.Clinical characteristics were compared between ruptured aneurysm group(RAG,n=230)and unruptured aneurysms group(URAG,n=115).Logistic regression analysis was performed to analyze the anatomy of venous sinus and clinical features including smoking history,hypertension,diabetes,location and size of the aneurysm in patients with intracranial aneurysm rupture.Results There were significant differences in had statistical significance with the patients'drinking history,smoking history,hypertension,diabetes,location and size of the aneurysm,as well as the dominant venous sinus on the same side as the aneurysm between rupture of intracranial aneurysm group and unruptured aneurysms group(P<0.05).Multivariate logistic regression analysis suggested that diabetes(OR=10.567),anterior communication(OR=2.214),posterior communication(OR=2.932),small aneurysms(OR=3.841),dominant venous sinus on the same side as the aneurysm(OR=1.736)were independent risk factors for rupture of the unruptured aneurysm.In addition,the dominant side of transverse sinus were more likely to form intracranial aneurysms(P<0.001).Conclusion The predisposing factors for rupture of intracranial aneurysms are anterior communication,posterior communication,small aneurysms and dominant lateral venous sinuses on the same side as aneurysms.Ipsilateral aneurysms are more likely to form in patients with dominant venous sinuses and can be used to accurately predict aneurysm rupture.
作者
刘忠
徐睿
张晓冬
朱继
LIU Zhong;XU Rui;ZHANG Xiaodong;ZHU Ji(Department of Neurosurgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2019年第11期641-646,共6页
Chinese Journal of Nervous and Mental Diseases
