杨彦昊



高龄颅内动脉瘤患者行血管内治疗后脑血管痉挛的临床分析

杨彦昊

【摘要】目的 分析高龄颅内动脉瘤行血管内治疗后的脑血管痉挛的发生情况。方法 选取我院急诊手术救治的99例高龄颅内动脉瘤者为研究组，选取同期救治的98例中青年颅内动脉瘤患者为对照组，对比组间术后脑血管痉挛发生率、GOS评分和mRS评分结果。结果 研究组术后脑血管痉挛发生率、mRS评分高于对照组，GOS评分低于对照组，组间数据差异具有统计学意义（P＜0.05）。结论 与中青年患者相比，高龄颅内动脉瘤患者在血管内治疗后更容易发生脑血管痉挛、神经功能恢复效果更差，建议临床重视防治。

【关键词】颅内动脉瘤；脑血管痉挛；血管内治疗；高龄

Objective To analyze the occurrence situation of the cerebral vasospasm after endovascular treatment in elderly patients with intracranial aneurysms. Methods 99 cases of elderly intracranial aneurysms patients were selected in our hospital as the study group，98 cases of young patients with intracranial aneurysm as control group in the same period. The postoperative cerebral vasospasm incidence，Gos score and mRS results were compared between the two groups. Results In the study group，the incidence rate of cerebral vasospasm and mRS results after operation were significantly higher than that in the conventional group，GOS score was lower than that of the control group（P＜0.05），there were significant differences between the data from two groups. Conclusion When compares with young and middle-aged patients，cerebral vasospasm is more likely to occur in the elderly patients with intracranial aneurysms after the endovascular treatment，the neurological function recovery effect is even worse，prevention and treatment is recommended.

【Key words】 Intracranial aneurysm，Cerebral vasospasm，Endovascular treatment，Elderly

颅内动脉瘤是指颅内动脉壁发生病理性改变，在局部动脉壁形成囊性膨出，其发生率位于脑血管意外性事件第3位［1-2］。颅内动脉瘤破裂具有较高病死率，积极治疗极为重要，由于动脉瘤发生率和年龄具有相关，因此，本实验通过对比不同年龄段颅内动脉瘤患者在血管内治疗的效果，旨在分析该病预后和年龄的关系，现总结如下。

1　资料和方法

1.1研究对象

选取我院在2014年1月～2016年1月接受血管内治疗的颅内动脉瘤患者≥70岁的99例为研究组，包括55例男性，44例女性，年龄71～82岁，中位年龄75岁，Hunt-Hess分级≤Ⅱ级46例，≥Ⅲ级53例；低于60岁的98例为对照组，包括56例男性，42例女性，年龄41～60岁，中位年龄45岁，Hunt-Hess≤Ⅱ级44例，≥Ⅲ级54例。两组间性别、就诊时间、Hunt-Hess等级分布等对比，P＞0.05。病例择取和剔除标准［3］：（1）经血管造影确诊颅内动脉瘤；……