Objective In
cerebral aneurysm clipping and embolization,
blood pressure control and temporary
parent artery blocking are common
methods to prevent
aneurysm rupture. Their influence on the
prognosis is uncertain. In this study, we try to find out the
association between
methods above and prognostic
indicators.
Methods We held a retrospective
analysis on
patients'
medical records of
cerebral aneurysms surgical clipping and endovascular coiling , and recorded
gender, age,
diagnosis, Hunt-Hess grade,
Glasgow coma scale score,
treatment methods, a
history of
hypertension, preoperative systolic
blood pressure, with or without
controlled hypotension, systolic
blood pressure difference before and after
controlled hypotension, with or without temporary
artery blocking, with or without
hypertension after treated
aneurysm, prognostic
indicators including
mortality after 1 month,
intensive care unit (ICU) stay
time of
survivors, discharged
Glasgow outcome scale (GOS) score. Prognostic
indicators were regarded as dependent variable, all the factors were regarded as independent variable, and the strength
analysis of influence factors on prognostic
indicators was made by binary
logistic regression.Results Total cases were 165, including 68
males and 97
females, with an average age of 56 (12-85) years. The
mortality after 1 month was 10.9% (18 cases). The ICU stay
time of
survivors was 7.35 (0-67) days. GOS score at discharge was 1-3 in 40 (24.2%)
patients and 4-5 in 125 (75.8%)
patients. Systolic
blood pressure difference before and after
controlled hypotension was an independent factor influencing
mortality (t=2.273, P=0.024), and the greater the difference was, the higher the
mortality would be. Timely
hypertension after
aneurysm treated was an independent factor affecting ICU stay
time of
survivors and
patients with
hypertension had shorter ICU stay
time (χ=10.017, P=0.001).
Blood pressure control (χ=0.088, P=0.767) and temporary blocking (χ=1.307, P=0.253) did not show significant influence on GOS score at discharge.Conclusions Timely controlled
hypertension after
aneurysm clipping and embolization can significantly shorten the stay
time in ICU. The degree of
controlled hypotension associates with postoperative
mortality, the greater systolic
blood pressure difference before and after
antihypertensive treatment is, the higher the
mortality will be.