基于Cox模型的颅内动脉瘤血管内介入疗效及预后不良的影响因素分析 ^*

Analysis of factors influencing the efficacy and poor prognosis of endovascular interventional therapy for intracranial aneurysms based on Cox model

摘要

目的 探究颅内动脉瘤血管内介入治疗效果及预后不良的影响因素。方法 选取2021年1月—2023年12月南京医科大学第一附属医院神经外科进行动脉瘤介入治疗的老年患者90例作为研究对象, 按照颅内动脉瘤的栓塞程度将其分为完全栓塞组 (61例) 和非完全栓塞组 (29例), 又根据改良Rankin量表评分分为预后良好组 (55例) 和预后不良组 (35例), 所有患者均采取颅内动脉瘤血管内介入治疗, 分别对造成患者非完全栓塞以及预后不良的危险因素进行单因素分析, 将差异具有统计学意义 (P<0.05) 的指标采用多因素COX回归分析影响治疗效果以及不良预后的危险因素。结果 不同治疗效果以及预后患者的年龄、吸烟史、高血压、糖尿病、高脂血症、动脉瘤大小、动脉瘤类型、Hunt-Hess分级、合并血肿比较, 差异均有统计学意义 (P<0.05), 多因素COX回归分析显示年龄、吸烟史、高血压、糖尿病、高脂血症、动脉瘤大小、动脉瘤类型、Hunt-Hess分级、合并血肿均为治疗效果和预后不良的独立影响因素 (P<0.05)。结论 在颅内动脉瘤血管内介入治疗前和治疗后, 应及时针对危险因素进行相应的治疗措施, 以降低患者不良预后的发生风险。

Abstract

Objective To explore the effect of endovascular interventional therapy for intracranial aneurysms and the influencing factors of poor prognosis. Methods A total of 90 elderly patients who underwent interventional therapy for aneurysms in the Department of Neurosurgery, the First Affiliated Hospital with Nanjing Medical University from January 2021 to December 2023 were selected as the research subjects. According to the degree of embolization in intracranial aneurysm, they were divided into the complete embolization group (61 cases) and the incomplete embolization group (29 cases). They were also divided into the good prognosis group (55 cases) and the poor prognosis group (35 cases) based on the modified Rankin Scale score. All patients received endovascular interventional therapy for intracranial aneurysms. Univariate analysis was performed to identify the risk factors for incomplete embolization and poor prognosis in patients, respectively. The indicators with statistically significant differences (P<0.05) were subjected to multivariate Cox regression analysis to explore the risk factors influencing treatment efficacy and poor prognosis. Results Comparisons of age, smoking history, hypertension, diabetes mellitus, hyperlipidemia, aneurysm size, aneurysm type, Hunt-Hess grade, and presence of hematoma among patients with different treatment effects and prognoses showed statistically significant differences (P<0.05). Multivariate Cox regression analysis indicated that age, smoking history, hypertension, diabetes mellitus, hyperlipidemia, aneurysm size, aneurysm type, Hunt-Hess grade, and presence of hematoma were all independent influencing factors for treatment effects and poor prognosis (P<0.05). Conclusion Before and after endovascular interventional therapy for intracranial aneurysms, corresponding nursing measures should be promptly implemented targeting the risk factors to reduce the risk of adverse prognosis in patients.

关键词

颅内动脉瘤 / 介入治疗 / 不良预后 / 危险因素

Key words

Intracranial aneurysm / Interventional therapy / Poor prognosis / Risk factors

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基金资助

^*国家自然科学基金项目(82303835)