| Objective:Retrospective analysis of clinical data and treatment effect of 41 patients with intracranial aneurysms in Jinan Central Hospital.To explore the relationship between the treatment effect and preoperative Hunt-Hess classification,gender,age,history of hypertension,intracranial aneurysm location,aneurysmal neck and size of intracranial aneurysms.To identify the risk factors affecting the treatment effect of patients,to make clinical judgments and to develop the effective intervention strategies,and to further improve the treatment effect of patients.Method:Retrospective analysis of 41 patients with intracranial aneurysms treated with interventional embolization at Jinan Central Hospital from January to February 2018,the inclusion criteria were:All patients underwent spiral CT examination to exclude infection and traumatic factors.The patient was diagnosed as SAH;the selected patients underwent DSA before surgery and were diagnosed as intracranial aneurysms;all patients were treated with endovascular embolization in Jinan Central hospital.Analyze the patient's clinical data and related follow-up information,including patient name,gender,age,admission and operation time,hospitalization number,Hunt-Hess classification,intracranial aneurysm location,aneurysm size,aneurysmal neck,history of hypertension,postoperative MRS(Modified Rankin Scale)score,contact information,angiographic follow-up and other data.The patient's treatment effect was evaluated using a modified Rankin Scale(MRS).The MRS score was 0 to 2 points,indicating a good treatment effect;the MRS score was 3 to 6 points,indicating a poor treatment effect.The MRS score was used as the dependent variable.The factors that may affect the treatment effect of patients with interventional therapy were independent variables.The ?2 test was used for single factor statistical analysis,Exact logistic analysis was performed using stata 14.0 software.Find out the factors that are relevant for the treatment effect of interventional treatment of intracranial aneurysms.Results:1.Of the 41 patients in this study,13 were male and 28 were female.The ratio of female to male patients was 2.2:1.Among the male patients,9 had good treatment effect and 4 had poor treatment effect.Among female patients,19 had good treatment effect and 9 had poor treatment effect.Univariate statistical analysis showed no significant difference between the two groups(?2=0.008,P--0.93),the precise logic analysis showing that OR=1.896(0.237?31.486),P=0.667.Gender was not a risk factor for the interventional outcome of intracranial aneurysms.2.Of the 41 patients in this study,the youngest patient was 26 years old and the oldest patient was 81 years old.The average age was 58.44± 2.09 years old.In this study,there were 20 patients<60 years old,including 17 patients with good treatment effect and 3 patients with poor treatment effect.There were 21 patients with?60 years old,including 11 patients with good treatment effect and 10 patients with poor treatment effect.Univariate statistical analysis showed significant differences between the high and low age groups(?2=5.034,P=0.93),the precise logic analysis showing that OR=5.071(0.382?+Inf),P=0.667,So the age is not a risk factor affecting the treatment effect of intracranial aneurysms.3.Of the 41 patients in this study,Hunt-Hess grade 0 was 0,11 was grade I,13 was grade II,7 was grade ?,5 was grade IV,and 5 were grade V.Among them,grades 0 to II were low grade group,24 cases;grades III to V were high grade group,and there were 17 cases.There were 23 patients with poor treatment effect in the low-grade group and 1 patient with poor treatment effect.The patients with high-grade group had 5 patients with good treatment effect and 12 patients with poor treatment effect.Univariate statistical analysis showed significant difference between the two groups(?2=20.275,P=0.001),the precise logic analysis showing that OR=58.158(6.243?+Inf),P<0.001.Preoperative Hunt-Hess grading is a risk factor for the interventional outcome of intracranial aneurysms.4.Of the 41 patients in this study,18 had a history of hypertension and 23 had no history of hypertension.Among patients with a history of hypertension,12 had a good treatment effect and 6 had a poor treatment effect.Among patients without a history of hypertension,16 had a good treatment effect and 7 had a poor treatment effect.According to single factor statistical analysis,the difference between the two groups was not statistically significant(?2=0.039,P=0.843),the precise logic analysis showing that OR=0.686(0?6.935),P=0.750.Hypertension was not a risk factor for interventional therapy in patients with intracranial aneurysms.5.Of the 41 patients in this group,25 had anterior circulation aneurysms and 16 had posterior circulation aneurysms.Among the patients with anterior circulation aneurysm,there were 17 patients with good treatment effect and 8 patients with poor treatment effect.Among the patients with posterior circulation aneurysm,there were 11 patients with good treatment effect and 5 patients with poor treatment effect.Univariate statistical analysis showed that(?2=0.003,P=0.960),the difference was not statistically significant.The precise logic analysis showing that OR=1.618(0.1.7?59.810),P=1.000.The location of intracranial aneurysm was not a risk factor affecting the treatment effect of intracranial aneurysm interventional therapy.6.Of the 41 patients in the study,18 patients had a wide-neck aneurysm[tumor neck?4 mm and/or body-neck ratio?2],of which 12 patients had a good treatment effect and 6 patients had a poor treatment effect;a narrow carotid artery There were 23 patients with tumors,of which 16 had a good treatment effect and 7 had a poor treatment effect.Univariate statistical analysis(?2=0.039,P=0.843),the difference between the two groups was not statistically significant.The precise logic analysis showing that OR=3.660(0.288?120.362)),P=0.3.93.The neck was not a risk factor for the treatment effect of interventional treatment of intracranial aneurysms.7.Among the 41 patients in this study,26 patients had intracranial aneurysms<5 mm in diameter,of which 18 patients had a good treatment effect,8 patients had a poor treatment effect;15 patients with an intracranial aneurysm diameter of 5-10 mm were 15 patients.Among them,10 patients had a good treatment effect,and 5 patients had a poor treatment effect;0 patients with intracranial aneurysms>10 mm in diameter had 0 patients.According to the single factor analysis(?2=0.039 P=0.865),the difference was not statistically significant.The precise logic analysis showing that OR=7.338(0.670?+Inf),P=0.108.The diameter of the intracranial aneurysm was not a risk factor affecting the treatment effect of intracranial aneurysms.Conclusion:Preoperative Hunt-Hess grading in patients with intracranial aneurysms is associated with the treatment effect of interventional procedures.It can be used to assess the treatment effect of patients,assist in the development of optimal treatment options,and improve the treatment effect of patients.There was no significant correlation between gender,age,presence of hypertension,intracranial aneurysm location,neck width,tumor size,and treatment effect of interventional therapy. |
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