| Part Ⅰ: Construction of a multicenter cerebral aneurysm databaseObjective: To complete the construction of a multi-center cerebral aneurysm database in China by collecting data on cerebral aneurysms from neurosurgery in many medical centers across the country,and to promote new methods and new ideas for the study of cerebral aneurysms.It will provide a real,effective and convenient data platform for the research and development of the diagnosis and treatment of cerebral aneurysms in China.To provide large data samples for the discovery of cerebral aneurysm sensitive genes in China.Method: Using SQL Server pattern framework,through different programming languages,convenient,safe and efficient cloud server,combined with the professional knowledge of clinical cerebrovascular disease,to build a multi-dimensional,high-fidelity,convenient and fast cloud database.Results: The cloud multi-center cerebral aneurysm database has been completed and achieved remarkable results.At present,29 hospitals are involved,distributed in 10 provinces and cities,most of which are provincial and municipal top hospitals,covering more than 100 million people.A total of more than 1,000 eligible cases were collected,covering both routine treatment of cerebral aneurysms and cases of unconventional aneurysms.A total of more than 400 blood samples were collected from patients with cerebral aneurysms.Conclusion: It is feasible to construct a reasonable,safe and effective multi-center cerebral aneurysm database through the current advanced computer technology.The use of the cerebral aneurysm database provides a good working platform for the diagnosis and treatment of cerebral aneurysms.The multi-center database platform has an incomparable advantage over the conventional single-center database because of its wide geographical distribution and large population coverage.It is worth promoting and further mining.Part Ⅱ: Analysis of factors influencing the efficacy of anterior communicating aneurysmsObjective: To analyze and explore the influencing factors of the efficacy of anterior communicating aneurysms,and to guide the clinical diagnosis and treatment of anterior communicating aneurysms;Methods: The cases of qualified anterior communicating aneurysms in CMAD were summarized.A total of 187 cases admitted to the hospital from January to February 2018 were selected.,which was admitted to 13 third-grade hospitals such as the General Hospital of Tianjin Medical University.The clinical data of age,past medical history and surgical procedure were counted.The m RS score scale at the time of discharge was used as an indicator to evaluate the efficacy.The risk factors affecting the patient’s efficacy were retrospectively analyzed.Results: Of the 187 patients,95 were male and 92 were female.The mean age was 54.73±11.835 years,and the average length of hospital stay was 20.99±20.869.Multivariate binary logistic regression analysis showed age(P<0.05,OR=1.062),treatment(P<0.05),CT Fisher classification(P<0.05,OR=3.827),PAASH score(P <0.05,OR=48.005),postoperative complications(P<0.05,OR=15.580)had statistically significant effects on the efficacy;they were an independent risk factor for the efficacy of patients with anterior communicating aneurysms.Conclusions: 1.Age,treatment,CT Fisher classification at admission,PAASH score at admission,and whether there were complications during hospitalization were significantly associated with the efficacy of patients with anterior communicating aneurysms;2.Short-term efficacy of microsurgery and interventional surgery Differences,long-term efficacy needs further follow-up;3,conservative treatment is less effective than surgical treatment;4,neurosurgical beds >200 groups have better efficacy than ≤50 group. |
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