摘要
目的 比较手术夹闭和血管内栓塞两种方法治疗后交通动脉动脉瘤（PcomAA）所致动眼神经麻痹（ONP）的疗效及其影响因素.方法 回顾性分析2008年6月-2012年5月,四川省人民医院神经外科收治的176例PcomAA同时伴有ONP患者的临床资料.其中手术夹闭132例,血管内栓塞治疗44例.比较两组患者的年龄、性别、动脉瘤大小、是否破裂、治疗间隔时间以及治疗时间、术前ONP程度及术后12个月的ONP恢复程度,采用多因素Logistic分析方法分析影响ONP恢复程度的因素.结果 176例PcomAA瘤患者中,最终ONP完全恢复137例（77.8%）,部分恢复25例（14.2%）,无恢复14例（8.0%）.（1）手术夹闭组132例中,有SAH 73例,无SAH 59例,最终ONP完全恢复123例（93.2%）,部分恢复7例（5.3%）,无恢复2例（1.5%）;血管内栓塞组44例中,有SAH 26例,无SAH 18例,最终ONP完全恢复14例（31.8%）,部分恢复18例（40.9%）,无恢复12例（27.3%）.（2）对ONP术后恢复情况进行多因素Logistic回归分析,不同的治疗方法是ONP恢复的独立影响因素（OR=36.368,95%CI：7.556- 47.603,P＜0.01）.结论与血管内栓塞比较,手术夹闭使 PcomAA导致的ONP恢复疗效更加显著.
Objective To compare the effects of surgical clipping or endovascular embolization on posterior communicating artery aneurysm （PeomAA） caused oculomotor nerve palsy （ONP） and its influencing factors. Methods The clinical data of 176 PcomAA patients with ONP treated at the Department of Neurosurgery, Sichuan Provincial People＇s Hospital from June 2008 to May 2012 were analyzed retrospectively. One hundred thirty-two patients were treated with surgical clipping and 44 patients were treated with endovascular embolization. The age, sex, size of aneurysm, rupture or not, treatment interval, therapeutic duration, preoperative degree of ONP, and postoperative recovery degree of ONP were compared between the 2 groups. Multivariate logistic analysis was used in this study. The follow-up duration was 12 months. Results In the 176 patients with PcomAA, 137 （77.8%） with ONP recovered completely, 25 （ 14.2% ） recovered partially, and 14 （ 8.0% ） did not recover. （ 1 ） Of the 132 patients in the surgical clipping group, 73 had subarachnoid hemorrhage （SAH） and 59 did not have SAH. Finally, 123 （93. 2%） patients with ONP recovered completely, 7 （5. 3%） recovered partially, and 2 （ 1.5 % ） did not recover. Of the 44 patients treated with endovascular embolization, 26 had SAH, and 18 did not have SAH. Finally, 14 （31.8%） patients with ONP recovered completely, 18 （40. 9% ） recovered partially, and 12 （27. 3% ） did not recover. （2）Muhivariate logistic regression analysis was performed in the postoperative recovery of ONP and the different treatment methods were the independent influence factors for ONP recovery （OR=36.368, 95%C17.556-47.603,P〈0.01）. Conclusion Surgicalclipping may recover PcomAA caused oculomotor nerve palsy effectively, the efficacy is more significant than endovascular embolization.
出处
《中国脑血管病杂志》
CAS
2014年第1期19-22,共4页
Chinese Journal of Cerebrovascular Diseases
关键词
颅内动脉瘤
动眼神经损伤
后交通动脉动脉瘤
开颅夹闭术
血管内栓塞术
Intracranial aneurysm
Oculomotor nerve injuries
Posterior communicating arteryaneurysm
Surgical clipping
Endovascular embolization
