Study On The Influencing Factors Of DCI After Endovascular Intervention For BBA In Tibet

Significance: Blood blister-like aneurysm(BBA)has a higher morbidity and fatality rate than other aneurysms and aneurysm is risky and difficult to operate.However,the incidence of blood vesicular aneurysm in Xizang is higher than domestic and foreign statistics.Delayed cerebral ischemia(DCI)is a common complication of hemorrhage in Subarachnoid hemorrhage(SAH)after aneurysm rupture,with high incidence.At the same time,it is also an important reason for the poor prognosis and quality of life decline of patients,such as motor dysfunction,cognitive dysfunction,and even life-threatening in severe cases.Exploring the influencing factors of DCI can help physicians predict the possibility of the occurrence of DCI,help timely detect and deal with DCI,guard against the occurrence of postoperative complications,ensure the reduction of the impact of DCI on patients,improve the prognosis and improve the quality of life.Methods: Patients with hematovesicular aneurysm who received interventional treatment in the Neurosurgery Department of Tibet Autonomous Region People’s Hospital from January 2015 to June 2022 and met the inclusion criteria were selected as the study objects.Based on whether patients had DCI or not,patients meeting the inclusion and exclusion criteria were divided into the group with DCI and the group without DCI.Baseline indicators of patients: gender,age,smoking history,drinking history,history of hypertension,history of hyperglycemia,laboratory test indicators: White blood cell count,Neutrophil to lymphocyte ratio(NLR),hemoglobin volume,C-reactive protein,timing of surgery,Hunt-Hess score and Fisher score as study factors,Whether it is related to the occurrence of DCI as a single factor was explored respectively.Meanwhile,multi-factor analysis was conducted to study the single factor with statistical significance.Results: A total of 206 cases meeting the inclusion and exclusion criteria were collected.Univariate analysis suggests: There were no significant differences in age,gender,history of hypertension,diabetes,smoking and drinking history,hemoglobin,and timing of operation among different groups(P>0.05),while there were significant differences in white blood cell count,NLR value,CRP,Hunt-Hess score,and modified Fisher score among different groups(P<0.05),indicating the above five factors It is correlated with the incidence of DCI in patients with BBA after intervention in Xizang,and can be used as an influencing factor.Multivariate analysis suggested that Hunt-Hess score and modified Fisher score were independent risk factors for DCI in patients with BBA after intervention in Xizang.Conclusion: When BBA patients are admitted to hospital,when white blood cell count g≥10×109/L,NLR≥5.9,CRP≥27mg/L,Hunt-Hess score≥4,and modified Fisher score ≥3,clinicians should pay enough attention and adopt appropriate monitoring means to evaluate intracranial blood supply of patients.To prevent and monitor the occurrence of DCI,and make timely and effective treatment of its occurrence,so as to obtain a better prognosis of patients and improve the quality of life of patients.