大脑中动脉瘤破裂后颅内血肿形成的危险因素及对预后的影响

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【中图分类号】 R743.35 【文献标志码】 B 【文章编号】1672-7770（2025）04-0466-06

Intracerebral hematoma due to ruptured middlecerebral artery aneurysm：therisk factorsand influence on outcome ZHOU Jiafeng， CHEN Chuankai，XIA Nengzhi， ZHU Dongqin， XIONG Ye， YANG Yunjun，CHEN Yongchun. DepartmentofRadiology，theFirstAffiliatedHospitalofWenzhou MedicalUniversity，Wenzhou325015，China Correspondng author：CHEN Yongchun

Abstract：ObjectiveTo explore therisk factors for intracranial hematoma（ICH）formationafter rupture of middle cerebral artery（MCA）aneurysm and the impact on prognosis.MethodsThe clinical data of 4O2 patients withrupturedMCAaneurysm intheFirstAfliated HospitalofWenzhou MedicalUniversityfromJanuary 2009 to June 202O wereanalyzed retrospectively.Univariateand multivariate Logisticregresson analysis wereusedon the clinicalandaneurysm morphology parametersofpatientsto identify therisk factorsofICH formation. ResultsPatients with ICH were more likely to have unfavourable outcome compared to those without ICH（ 35.9% vs 10.2% ， P<0.001 ）.Mixed ICH patients were more likely to have unfavourable outcomes compared to single location ICH patients（ 57.9% us 26.9% ， P=0.001 ）.Multivariate analysis revealed that age（ OR=1.02，95% CI=1.00-- （204号 （204 1.04，P=0.049 ），aneurysm size ，AR（ （204 （204号 1.16-2.74，P=0.008， ，and the superior projection of the aneurysm dome（ OR=1.79，95%CI=1.06-3.01 ， P=0.029 ）were risk factors of the formation of ICH.ConclusionsPatients with mixed ICH were more likely to haveunfavourableoutcome.Advanced age，larger aneurysm size，larger AR，and superior projection of the aneurysm dome were risk factors for ICH formation afterMCAaneurysm repture.These findings were helpful for the management of patients with unruptured aneurysms.

Keywords：intracranial aneurysm；middlecerebralartery；intracerebral hematoma; aneurysm morphology；outcome

颅内动脉瘤破裂后除了会引起蛛网膜下腔出血（subarachnoidhemorrhage，SAH）之外，也会伴有颅内血肿（intracerebralhematoma，ICH）形成，其发生率为 25% ～48%[1-2] 。（剩余10580字）