Rupture Factors And Treatment Contrast Of Intracranial Aneurysms

Objective:To discuss the relationship between longest diameter and location of intracranial aneurysms,hypertension,diabetes,hyperlipidemia,long-term smoking history,long-term drinking history,sex,age and aneurysm rupture.And the differences of postoperative complications,hospitalization cost and postoperative hospital stay in intracranial aneurysm clipping by craniotomy and intracranial aneurysm embolization.Methods:We retrospectively analyzed the clinical data of 156 cases of patients with intracranial aneurysms who admitted in second affiliated hospital of KunMing medical university from January 2015 to March 2018,including 125 cases of ruptured aneurysms,31 cases of unruptured aneurysms,76 cases of aneurysm clipping,80 cases of aneurysm embolization.All cases were divided into 4 groups,ruptured group,unputured group,clipping group and coiling group.We recorded the characteristics of aneurysms,patient’s age,sex,relevant medical history,surgical methods and other clinical data.The mean value of the two groups was compared by the independent sample T test,and the counting data was checked by chi-square test.Results:1.There was a statistical significance in mean longest diameter between ruptured group and unputured group(t=-4.554,P<0.05),and a statistical significance was found in aneurysms in which the longest diameter was less than 6mm,ranging from 6mm to 9mm and more than 9mm(x2=10.985,P<0.05).2.There was a statistical significance of aneurysm rupture rate in different locations(x2=18.966,P<0.05)3.The aneurysm rupture rate in patients with hypertension was higher than those without hypertension,and there was a statistical significance(x2=4.765,P<0.05).4.The aneurysm rupture rate in patients without hyperlipidemia was higher than those with hyperlipidemia,and there was a statistical significance(x2=9.358,P<0.05).5.There was no statistical significance about aneurysm rupture rate in diabetes,long-term smoking history,long-term drinking history,sex and age(P<0.05).6.There was a statistical significance in postoperative pulmonary infection,hypoproteinemia,hematoma,hydrocephalus,central diabetes insipidus,intracranial infection,lumbar puncture and tracheotomy between clipping group and coiling group(P<0.05)but no statistical significance in cerebral infarction.7.There was a statistical significance in mean hospitalization cost and mean postoperative hospital stay.Conclusions:1.The longest diameter of aneurysm is a risk factor for aneurysm rupture.Rupture rate in aneurysms whose longest diameter is less 6mm is highest.Rupture rate in aneurysms whose longest diameter ranges from 6-9mm ranks secondly.Rupture rate in aneurysms whose longest diameter is more than 9mm is lowest.2.Diabetes,long-term smoking history,long-term drinking history,sex and age are not risk factors for aneurysm rupture.3.Aneurysm clipping is easier than aneurysm embolization to cause postoperative pulmonary infection,hypoproteinemia,hematoma,hydrocephalus,central diabetes insipidus,intracranial infection.We need to do more lumbar puncture and tracheotomy by using aneurysm clipping than aneurysm embolization.4.There is no difference in cerebral infarction between aneurysm clipping and aneurysm embolization.5.Hospitalization cost and postoperative hospital stay is less by using aneurysm embolization than aneurysm clipping.