| ObjectiveTo evaluation the prognosis factors of aneurysm clipping craniotomy on patients with arterial aneurysm, and to find meaningful indicators though the statistical analysis of a variety of factors. To provide the help to clinical work, and to improve the prognosis of patients with arterial aneurysm.MethodsCollected Patients with ruptured intracranial aneurysm surgery from June 2011 -June 2015 in yantai hospital affiliated to Binzhou Medical school. All patients were given craniocerebral CT examination after admission, to confirm the diagnosis of spontaneous subarachnoid hemorrhage. All patients were given Fisher Classification according to intracerebral haemorrhage amount, and to the clinical classification according the patient's state of consciousness, the treatment of patients with strictly follow the standardization process of aSAH. To evaluation the prognosis of patients with the modified Rankin scale score in postoperative follow-up of 6 months, 0 -3 points for good prognosis, 4 -6 points for poor prognosis. Filtered in the follow-up to the hospital patients, a total of 229 people meet eligibility criteria. Selection of patient's age, sex, smoking history, Fisher grade, clinical stage, operation time, ruptured aneurysm secondary bleeding, the size of the aneurysm, the location of the aneurysm and symptomatic cerebral vasospasm (cerebral vasospasm, CVS) such as 10 factors affecting the prognosis of patients (10 indicators,26 levels). Using SPSS20.0 statistical software, first using the chi-square test, single factor analysis and statistical significance of the factors as independent variables, outcome as dependent variable, gives the Logistic regression analysis, finally determine the most valuable factors affecting prognosis.ResultsIn 229 patients with intracranial aneurysms, clip all surgery success, 186 (81.2%),good prognosis (modified Rankin scale score of 0 -3 points), the prognosis of defective rate is 18.8% (mRS score 4-6). Single factor analysis by chi-square test show that Age,Fisher, classification, clinical classification, ruptured aneurysm secondary on admission,symptomatic vasospasm factors to the prognosis of patients with significant difference,has statistical significance( p < 0.05), while sex, smoking history, and the size of the tumors, aneurysms parts (before/after cycle), timing of surgery, the prognosis of patients with such factors as possible and have a certain correlation, but is not a direct causal relationship. Multiariable Logistic regression analysis according to the results show that Age, Fisher grading, clinical grade on admission, symptomatic CVS has statistical significance (P < 0.05), suggesting the age, clinical classification and grading Fisher,symptomatic CVS has something to do with the long-term treatment outcome of patients, the regression coefficients were 1.869,1.505,2.032 B, Wald values were 5.558,6.604, 5.233, OR values were 6.480, 4.503 and 6.480, 95% CI (1.371-30.640),respectively (1.429-14.188) and (1.338 43.471).Conclusion1. Age, clinical classification and grading Fisher, symptomatic CVS is independent discriminant factor for affecting the prognosis of patients with intracranial single-shot aneurysm surgery, .Aneurysm prognosis related factors analysis can to assess the prognosis of patients with aneurysms to a certain extent, and to help guiding clinical work.2. Microsurgical operation is should be early after Intracranial aneurysm diagnosed, in case of an aneurysm rupture bleeding again, leading to fatal consequences.3. Active management of patients with postoperative complications can obviously reduce morbidity of death.4. If further determine the influence of related factors on the prognosis that must be forward-looking statistics and analysis, enlarging the sample size, multi-center clinical research and training specialized personnel in collecting information, develop a more accurate mathematical model. |
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