CAJ | 학술논문

目的：探讨颅内动脉瘤破裂后行外科治疗的患者影响其预后的相关因素及临床意义。方法回顾性分析218例动脉瘤破裂后行外科手术治疗患者的病案资料，包括一般资料、入院时 Hunt‐hess 分级、手术方式等。患者预后情况采用出院时格拉斯哥预后评分（GOS）作为评价标准。先对可能的因素进行单因素分析，再将单因素分析有统计学意义的因素纳入多因素 Lo‐gistic 回归分析。结果单因素分析提示患者年龄、入院时 Hunt‐hess 分级、高血压、手术方式、CT Fisher 分级、症状性血管痉挛与预后显著相关（P＜0．05），多因素分析提示年龄、入院时 Hunt‐hess 分级、症状性血管痉挛、CT Fisher 分级是影响患者预后的独立危险因素（P＜0．05）。结论患者年龄、入院时 Hunt‐hess 分级、症状性血管痉挛、CT Fisher 分级能显著影响颅内动脉瘤破裂后外科治疗患者的预后，重视这些指标的预测价值对降低患者术后病死率和致残率具有重要临床意义。
목적：탐토로내동맥류파렬후행외과치료적환자영향기예후적상관인소급림상의의。방법회고성분석218례동맥류파렬후행외과수술치료환자적병안자료，포괄일반자료、입원시 Hunt‐hess 분급、수술방식등。환자예후정황채용출원시격랍사가예후평분（GOS）작위평개표준。선대가능적인소진행단인소분석，재장단인소분석유통계학의의적인소납입다인소 Lo‐gistic 회귀분석。결과단인소분석제시환자년령、입원시 Hunt‐hess 분급、고혈압、수술방식、CT Fisher 분급、증상성혈관경련여예후현저상관（P＜0．05），다인소분석제시년령、입원시 Hunt‐hess 분급、증상성혈관경련、CT Fisher 분급시영향환자예후적독립위험인소（P＜0．05）。결론환자년령、입원시 Hunt‐hess 분급、증상성혈관경련、CT Fisher 분급능현저영향로내동맥류파렬후외과치료환자적예후，중시저사지표적예측개치대강저환자술후병사솔화치잔솔구유중요림상의의。
Objective To investigate the prognostic related factors in the patients with ruptured intracranial aneurysm treated by surgical treatment and their clinical significance .Methods The medical record data in 218 cases of ruptured aneurysm treated by operative treatment were performed the retrospective analysis ,including th egeneral data ,Hunt‐Hess grade on admission ,surgical procedure ,etc .The patient′s prognosis situation adopted the Glasgow outcome scale(GOS) as the evaluation standard when dis‐charge from hospital .Firstly the possible factors were performed the single factor analysis ,then the factors with statistic signifi‐cance in the single factor analysis were performed the multiple factors logistic regression analysis .Results The single factor analy‐sis indicated that the age ,Hunt‐Hess grade on admission ,hypertension ,operation mode ,CT Fisher grading and symptomatic vaso‐spasm were significantly correlated with the prognosis ( P < 0 .05) .The multiple factors analysis indicated that age ,Hunt‐Hess grade on admission ,symptomatic vasospasm ,CT Fisher grading were the independent risk factors affecting the prognosis of patients (P< 0 .05) .Conclusion The patients′ age ,Hunt‐Hess grade on admission ,symptomatic vasospasm and CT Fisher grading can sig‐nificantly affect the prognosis of the patients with ruptured intracranial aneurysm after surgical treatment .Paying attention to the predictive value of these predictors has important clinical significance to reduce the postoperative mortality rate and disability rate in the patients with ruptured intracranial aneurysm .