To Analysis The Related Risk Factors Rebleeding Of Intracranial Ruptured Aneurysms

Objective To investigate the analysis of intracranial aneurysm rebleeding risk factors, incidence, time of occurrence, and provide evidence for the prevention and treatment of bleeding of aneurysm rupture to improve clinical outcomes in patients.Methods A retrospective analysis on clinical data, including clinical data, clinical data, imaging data, of 344 patients of aneurysm rupture hospitalized in Neurosurgery department of the First Affiliated Hospital of Guangxi Medical University from August 2012 to March 2015.All patients were confirmed by CTA and (or) DSA diagnosed with subarachnoid hemorrhage and all clinical variables were analyzed by univariate analysis and multivariate Logistic regression analysis to determine the rebleeding risk factors of the aneurysm rupture.Results Univariate analysis showed that at the first onset of loss of consciousness, cerebral arterial sclerosis, epilepsy, irregularly shaped aneurysm, whether timely diabetes treatment, the size of the aneurysm, bleeding form, Hunt-Hess grade, Fisher grade, and so on of rebleeding patients are significantly different (P<0.05), compared with that of non-bleeding patients, Multivariate Logistic regression analysis showed that cerebral arterial sclerosis, irregular aneurysm, loss of consciousness, epilepsy, diabetes, timely treatment are independent risk factors for rebleeding of aneurysm rupture(P<0.05).77 cases of rebleeding accounts for 22.4% of all patients, the shortest time interval and the longest of rebleeding patients are 1 h and 124 days each including 8 cases (10.4%) occurred within 6 hours,16 cases (20.8%) patients within 24 hours,28 cases (36.3%) after 24 hours to 7 days,16 cases (20.8%) in the first 2 weeks after hemorrhage rupture bleeding,16 cases (20.8%) patients after two weeks. 61 cases (79.2%) with ruptured bleeding occurs in less than two weeks; 19 patients (24.6%) patients with bleeding occurred three times including 14 cases (73.7%) patients after 24 hours-1 week,4 cases (21.0%) after 1 week, only 1 patient (5.3%) rebleeding within 24 hours. The mortality (35.0%) of rebleeding was significantly higher than non-rebleeding group (6.0%).Conclusion Cerebral arteriosclerosis, aneurysm irregular, loss of consciousness, epilepsy, diabetes and timely treatment are all independent risk factors for rebleeding of aneurysm rupture occurring. Cerebral arteriosclerosis is vascular lesions of ruptured aneurysm rebleeding and one cause of vascular etiology. Third bleeding occurred within one week after the second bleeding and the highest rate of bleeding within four days but the bleeding peak time is the fourth day. Mortality and morbidity of ruptured aneurysm rebleeding are both significantly increased.