早期诊断和积极干预对脑动脉瘤患者生存率影响.docVIP

早期诊断和积极干预对脑动脉瘤患者生存率影响 　　[摘要] 目的 探讨早期诊断和积极干预对脑动脉瘤患者死亡率的影响。方法 整群选取2010年6月―2012年12月该院收治的166例脑动脉瘤患者进行观察性研究，将体检筛查出的138例脑动脉瘤患者作为研究组，将28因脑动脉瘤破裂出血而就诊诊断为脑动脉瘤的患者作为对照组，比较两组患者的格拉斯哥昏迷评分（GOS）、死亡率以及存活患者的日常生活活动能力（Activities of Daily Living，ADL）的差异，Logistic 回归分析影响该类患者死亡的相关危险因素。 结果 研究组中GOS（2～3）分和（4～5）分患者比例分别为18.8%和60.9%，明显优于对照组，分别为32.1%和7.1%，其差异具有统计学意义（P0.05）。而且，研究组中ADL（I-Ⅲ）级和（IV-V）级患者比例分别为81.9%和18.1%，明显优于对照组，分别为21.4%和78.6%，其差异具有统计学意义（P0.05）。另外，研究组的死亡率为20.3%，明显低于对照组（60.7%），两组间差异有统计学意义（P0.05）。Logistic 回归结果显示：患者年龄、血压、动脉瘤大小、性质、部位以及干预时机是脑动脉瘤患者死亡的独立危险因素（P0.05）。 结论 早期诊断与积极干预能明显提高脑动脉瘤患者的生存率，进而改善患者的临床预后。 　　[关键词] 脑动脉瘤； 早期诊断；积极干预；生存率；预后 　　[中图分类号] R651 [文献标识码] A [文章编号] 1674-0742（2016）09（b）-0007-03 　　[Abstract] Objective To investigate the effect of early diagnosis and positive intervention on mortality in patients with intracranial aneurysm. Methods Group selection from June 2010 to December 2012， 166 patients with intracranial aneurysm in our hospital were observationally analyzed. They were divided into two groups： 138 patients accepting physical examination and detected with intracranial aneurysm as the study group and 28 cases in control group were diagnosed with intracranial aneurysm because of cerebral aneurysm subarachnoid hemorrhage. Glasgow Coma Scale （GOS）， ability of daily living （ADL） evaluation and mortality were compared between the two groups. And Logistic regression analysis was used to find the risk factors for mortality in patients with intracranial aneurysm. Results The percentage of GOS score（2～3） and （4～5） in study group was 18.8% and 60.9%??respectively， which was significantly better than the control group （32.1% and 7.1%） （P0.05）. And， the percentage of ADL grade（I-Ⅲ）and grade（IV-V） in study group was 81.9% and 18.1%，respectively， which was significantly better than the control group （21.4% and 78.6%），（P0.05）. The mortality in study group is 20.3%， which was significantly lower than that in control group （P0.05）.The result for Logistic regression analysis showed tha