眼动脉段动脉瘤夹闭术后视力下降的危险因素分析(1)
[摘要] 目的 探讨眼动脉段动脉瘤(OA)夹闭术后视力下降的危险因素。方法 回顾性分析开颅夹闭术治疗OA病人62例的临床资料。单因素方差分析动脉瘤形态、病人的临床特征与视力下降的关系，多因素Logistic回归分析与眼动脉瘤视力下降的危险因素。结果 62例OA病人中4例术后视力下降，其中3例为瘤体直径≥25 mm的OA病人。以术后视力下降作为因变量、将单因素分析后P<0.1的因素作为自变量，通过后退法进行多因素Logistic回归分析，结果显示动脉瘤直径≥25 mm为OA病人夹闭术后视力下降的独立危险因素(OR=14.642，95%CI=1.995～53.124，P<0.05)。结论 瘤体直径是OA夹闭术后视力下降的危险因素。
[关键词] 颅内动脉瘤;眼动脉段动脉瘤;开颅夹闭术;视力下降;危险因素
[中图分类号] R651 [文献标志码] A [文章编号] 2096-5532(2020)06-0649-04
doi：10.11712/jms.2096-5532.2020.56.169 [开放科学(资源服务)标识码(OSID)]
[网络出版] https：//kns.cnki.net/kcms/detail/37.1517.R.20200728.1426.011.html;
[ABSTRACT] Objective To investigate the risk factors for impaired vision after clipping of ophthalmic artery aneurysm. Methods A retrospective analysis was performed for the clinical data of 62 patients with ophthalmic artery aneurysm who underwent craniotomy and clipping. A one-way analysis of variance was used to investigate the association of aneurysm morphology and clinical features with impaired vision， and a multivariate Logistic regression analysis was used to analyze the risk factors for impaired vision in patients with ophthalmic artery aneurysm. Results Among the 62 patients with ophthalmic artery aneurysm， 4 expe-rienced impaired vision after surgery， among whom 3 had a diameter of aneurysm of ≥25 mm. The backward multivariate regression analysis was performed with impaired vision after surgery as the dependent variable and the factors with P<0.1 determined by the univariate analysis as the independent variables， and the results showed that diameter of aneurysm ≥25 mm (OR=14.642，95%CI=1.995-53.124，P<0.05) was an independent risk factor for impaired vision after clipping in patients with ophthalmic artery aneurysm. Conclusion Diameter of aneurysm is a risk factor for impaired vision after clipping of ophthalmic artery aneurysm.
[KEY WORDS] intracranial aneurysm; ophthalmic segment aneurysm; neurosurgical clipping; hypopsia; risk factors
頸内动脉眼动脉段动脉瘤(OA)是指颈内动脉眼动脉与后交通动脉之间发生的动脉瘤，发病率为0.5%～8.0%[1]。由于其邻近视神经血管、硬脑膜和前床突等复杂的解剖结构，操作空间小，宽颈的动脉瘤多，夹闭难度较大[2-3];同时，由于OA体积较大易导致视功能损伤，33%的病人会出现视力减退、视野缺损和视神经损伤等症状[4-5]。长期以来对于OA的研究多集中于不同手术术式与视野缺损、并发症等，很少有研究关注OA病人视力下降的有关因素。本文探讨夹闭术治疗OA后病人视力下降的危险因素，旨在为防止术后发生视力下降提供精准治疗。现将结果报告如下。
1 资料与方法
1.1 研究对象
对我院神经外科1996年6月—2019年6月期间收治的62例OA病人临床资料进行回顾性分析。病人男11例，女51例;年龄29～73岁，平均(54.9±9.3)岁。纳入标准：①经CTA或DSA检查确诊为OA;②术前进行视力或视野检查;③行OA开颅夹闭术治疗。排除标准：①合并有可能对预后造成影响的原发性脏器功能障碍;②多发性动脉瘤、颅内肿瘤、血管狭窄和血管造影畸形等病人。本文研究得到了我院伦理评审委员会的批准。, http://www.100md.com(卢冬林 熊静 刘恒健 陈百强 周汉 丰育功)
[关键词] 颅内动脉瘤;眼动脉段动脉瘤;开颅夹闭术;视力下降;危险因素
[中图分类号] R651 [文献标志码] A [文章编号] 2096-5532(2020)06-0649-04
doi：10.11712/jms.2096-5532.2020.56.169 [开放科学(资源服务)标识码(OSID)]
[网络出版] https：//kns.cnki.net/kcms/detail/37.1517.R.20200728.1426.011.html;
[ABSTRACT] Objective To investigate the risk factors for impaired vision after clipping of ophthalmic artery aneurysm. Methods A retrospective analysis was performed for the clinical data of 62 patients with ophthalmic artery aneurysm who underwent craniotomy and clipping. A one-way analysis of variance was used to investigate the association of aneurysm morphology and clinical features with impaired vision， and a multivariate Logistic regression analysis was used to analyze the risk factors for impaired vision in patients with ophthalmic artery aneurysm. Results Among the 62 patients with ophthalmic artery aneurysm， 4 expe-rienced impaired vision after surgery， among whom 3 had a diameter of aneurysm of ≥25 mm. The backward multivariate regression analysis was performed with impaired vision after surgery as the dependent variable and the factors with P<0.1 determined by the univariate analysis as the independent variables， and the results showed that diameter of aneurysm ≥25 mm (OR=14.642，95%CI=1.995-53.124，P<0.05) was an independent risk factor for impaired vision after clipping in patients with ophthalmic artery aneurysm. Conclusion Diameter of aneurysm is a risk factor for impaired vision after clipping of ophthalmic artery aneurysm.
[KEY WORDS] intracranial aneurysm; ophthalmic segment aneurysm; neurosurgical clipping; hypopsia; risk factors
頸内动脉眼动脉段动脉瘤(OA)是指颈内动脉眼动脉与后交通动脉之间发生的动脉瘤，发病率为0.5%～8.0%[1]。由于其邻近视神经血管、硬脑膜和前床突等复杂的解剖结构，操作空间小，宽颈的动脉瘤多，夹闭难度较大[2-3];同时，由于OA体积较大易导致视功能损伤，33%的病人会出现视力减退、视野缺损和视神经损伤等症状[4-5]。长期以来对于OA的研究多集中于不同手术术式与视野缺损、并发症等，很少有研究关注OA病人视力下降的有关因素。本文探讨夹闭术治疗OA后病人视力下降的危险因素，旨在为防止术后发生视力下降提供精准治疗。现将结果报告如下。
1 资料与方法
1.1 研究对象
对我院神经外科1996年6月—2019年6月期间收治的62例OA病人临床资料进行回顾性分析。病人男11例，女51例;年龄29～73岁，平均(54.9±9.3)岁。纳入标准：①经CTA或DSA检查确诊为OA;②术前进行视力或视野检查;③行OA开颅夹闭术治疗。排除标准：①合并有可能对预后造成影响的原发性脏器功能障碍;②多发性动脉瘤、颅内肿瘤、血管狭窄和血管造影畸形等病人。本文研究得到了我院伦理评审委员会的批准。, http://www.100md.com(卢冬林 熊静 刘恒健 陈百强 周汉 丰育功)