Functional outcome and quality of life after angiography and operation for unruptured intracranial aneurysms
Functional outcome and quality of life after angiography and operation for unruptured intracranial aneurysms
复制标题
未破裂颅内动脉瘤血管造影和手术后的功能结果和生活质量
DOI：
--
复制
发表时间：
2000
影响因子：
11
通讯作者：
T. W. Raaymakers
中科院分区：
文献类型：
--
作者：
T. W. Raaymakers
目的评价未破裂颅内动脉瘤选择性治疗后的预后。方法对193例蛛网膜下腔出血患者626例一级亲属（父母、兄弟姐妹、子女）进行磁共振血管造影筛查。随后，18名亲属接受了择期血管造影和手术。对术后3个月和1年的损伤（神经系统检查）、残疾（Barthel指数）、残疾（Rankin量表）和生活质量（疾病影响概况（SIP）和短表-36 (SF-36)）进行评估；将其与基线测量值进行比较。结果：血管造影前，所有患者神经系统检查正常，Barthel和Rankin评分最佳，生活质量与参考人群相似。术后3个月，5例患者（28%，95%可信区间（95% CI） 10-54%）出现神经功能障碍（1例血管造影后），2例（11%,95% CI 1-35%） Barthel指数下降，15例（83%,95% CI 59-96%） Rankin评分次理想（无日常生活依赖）。大多数领域的生活质量（SIP和SF-36）都有所降低。1年后，5例患者仍有神经损伤，所有患者Barthel指数均为最佳，8例（47%;95% CI 23-72%） Rankin评分为次优。所有SIP和大多数SF-36领域的生活质量恢复到基线水平。结论：尽管损伤率较低，但未破裂动脉瘤的治疗对大多数患者的功能健康和生活质量有相当大的短期负面影响。术后1年内预后明显改善，但不完全改善。
OBJECTIVES To assess outcome after elective treatment for unruptured intracranial aneurysms. METHODS Of 193 consecutive patients with subarachnoid haemorrhage 626 first degree relatives (parents, siblings, children) were screened with magnetic resonance angiography. Subsequently, 18 relatives underwent elective angiography and operation. Outcome was assessed in terms of impairments (neurological examination), disabilities (Barthel index), handicaps (Rankin scale), and quality of life (sickness impact profile (SIP) and short form-36 (SF-36)) 3 months and 1 year after operation; it was compared with baseline measurements. RESULTS Before angiography all patients had a normal neurological examination, optimal Barthel and Rankin scores, and a quality of life similar to that in a reference population. Three months postoperatively five patients (28%; 95% confidence interval (95% CI) 10–54%) had neurological impairments (one after angiography), two (11%; 95% CI 1–35%) had a decrease in Barthel index, and 15 (83%; 95% CI 59–96%) had suboptimal Rankin scores (none was dependent in daily living). Quality of life (SIP and SF-36) was reduced for most domains. After 1 year, five patients still had neurological impairments, all had an optimal Barthel index, and eight (47%; 95% CI 23–72%) had suboptimal Rankin scores. Quality of life returned to baseline levels for all SIP and most SF-36 domains. CONCLUSIONS Treatment of unruptured aneurysms has a considerable short term negative impact on functional health and quality of life in most patients, despite the low rate of impairments. Outcome improves markedly but not completely within 1 year after operation.