Ya Xiaolong, Zhang Chaoqi, Liu Jichao, Zhang Shuo, Zhang Qian, Wang Shuo, Cao Yong, Zhao Jizong
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Front Surg. 2020 Nov 12;7:587790. doi: 10.3389/fsurg.2020.587790. eCollection 2020.
To explore the influencing factors of volume hemorrhage in ruptured anterior circulation aneurysms, so as to identify the characteristics of anterior circulation aneurysms with high volume of hemorrhage, and to provide advice for clinical diagnosis and treatment for those aneurysms. We retrospectively reviewed 437 cases of ruptured anterior intracranial aneurysms in our center between the years 2012 and 2017. According to the inclusion criteria, a total of 100 qualified patients were screened out. We collected demographic characteristics, environmental exposure, and admission status of enrolled patients. In addition, morphological parameters and location of aneurysms were also included. The semiautomatic threshold method was used to measure the volume of hemorrhage. According to the results, the patients were divided into the group with high blood volume and low blood volume. Univariate and multivariate logistic regression analyses were used to discover the related factors affecting the bleeding volume. In univariable analysis, pulse pressure ( = 0.014) showed a significant difference at the < 0.05 test level. In terms of aneurysm morphology, the irregular shape ( < 0.001), calcification ( = 0.001), and flow angle ( = 0.006) showed significant statistical differences between the two groups at the < 0.01 level ( < 0.01). Multivariate logistic regression analysis showed that irregular shape (OR = 5.370 = 0.002 < 0.05), large flow angle (OR = 1.033 = 0.016 < 0.05), and calcification (OR = 5.460 = 0.003 < 0.05) were risk factors for volume of hemorrhage in ruptured anterior circulation aneurysms. The influence of hypertension history was at critical state (OR = 2.877 = 0.051 > 005). According to our analysis results, intracranial anterior circulation aneurysms with irregular shapes, calcifications, and large flow angle are more dangerous. Aneurysms with these characteristics often have a large amount of hemorrhage, requiring timely treatment in clinical practice.
为探讨破裂前循环动脉瘤出血量的影响因素，以明确高出血量前循环动脉瘤的特征，并为这些动脉瘤的临床诊断和治疗提供建议。我们回顾性分析了2012年至2017年间本中心437例破裂的颅内前循环动脉瘤病例。根据纳入标准，共筛选出100例合格患者。我们收集了入选患者的人口统计学特征、环境暴露情况及入院状态。此外，还纳入了动脉瘤的形态学参数和位置。采用半自动阈值法测量出血量。根据结果，将患者分为高出血量组和低出血量组。采用单因素和多因素logistic回归分析来发现影响出血量的相关因素。在单因素分析中，脉压（P = 0.014）在P < 0.05检验水准上显示出显著差异。在动脉瘤形态方面，不规则形状（P < 0.001）、钙化（P = 0.001）和血流角度（P = 0.006）在两组间P < 0.01水平上显示出显著统计学差异（P < 0.01）。多因素logistic回归分析显示，不规则形状（OR = 5.370，P = 0.002，P < 0.05）、大血流角度（OR = 1.033，P = 0.016，P < 0.05）和钙化（OR = 5.460，P = 0.003，P < 0.05）是破裂前循环动脉瘤出血量的危险因素。高血压病史的影响处于临界状态（OR = 2.877，P = 0.051，P > 0.05）。根据我们的分析结果，形状不规则、有钙化且血流角度大的颅内前循环动脉瘤更危险。具有这些特征的动脉瘤往往出血量较大，临床实践中需要及时治疗。
