摘要
目的评价血管内治疗破裂前交通动脉瘤的有效性及患者的总体预后。方法收集2014-03-2018-06行血管内介入治疗的60例破裂前交通动脉瘤患者的病例资料,分析动脉瘤栓塞率、术前术后GCS评分(Glasgow Coma Scale,GCS)、支架的使用、动脉瘤复发、并发症及GOS评分(Glasgow Outcome Scale,GOS)判断预后等。结果动脉瘤填塞Raymond分级:Ⅰ级50例,Ⅱ级6例,Ⅲ级4例;19例术中使用支架(支架组和非支架组在早期动脉瘤栓塞率差异无统计学意义,P=0.883);40例患者在术后1a内行DSA随访,8例出现动脉瘤复发(支架组与非支架组复发率差异无统计学意义,P=0.689);术后GCS评分较术前明显改善(Z=-3.741,P<0.01);末次随访患者GOS评分:5分43例,4分10例,3分4例,2分2例,1分1例;术后出现脑积水6例,脑梗死7例,肺部感染4例。结论个体化的血管内介入治疗破裂前交通动脉瘤安全有效并显著改善患者临床症状与预后。
Objective To evaluate the effectiveness of endovascular treatment of ruptured anterior communicating aneurysms(AcoA)and the overall prognosis of patients.Methods The data of 60 patients with ruptured AcoA who underwent endovascular intervention from March 2014 to June 2018 were collected.The aneurysm embolization rate,preoperative and postoperative GCS score,stent use,aneurysm recurrence,complications,and GOS score to determine prognosis.Results Raymond classification of aneurysm:50 cases of grade I,6 cases of gradeⅡ,4 cases of gradeⅢ;19 cases of stents used during the operation(the stenting group and the non-stent group had no statistical difference in early aneurysm embolization rate,P=0.883);Forty patients underwent DSA follow-up within 1 year after operation,and 8 patients had aneurysm recurrence(no difference in the recurrence rate between the stent group and the non-stent group,P=0.689).The postoperative GCS score was significantly improved compared with the preoperative(Z=-3.741,P<0.01);GOS score at the last follow-up:5 points in 43 cases;4 points in 10 cases;3 points in 4 cases;2 points in 2 cases;1 point in 1 case;postoperative hydrocephalus occurred in 6 cases,cerebral infarction In 7 cases,4cases of pulmonary infection.Conclusion Individualized endovascular intervention for the treatment of ruptured anterior communicating aneurysms is safe and effective and significantly improves the patients clinical symptoms and prognosis.
作者
程哲
闵敬亮
杨光
张辉
王昊
来汉生
CHENG Zhe;MIN Jingliang;YANG Guang;ZHANG Hui;WANG Hao;LAI Hansheng(The Second Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)
出处
《中国实用神经疾病杂志》
2018年第21期2331-2337,共7页
Chinese Journal of Practical Nervous Diseases
关键词
前交通动脉瘤
破裂动脉瘤
血管内介入治疗
并发症
预后
Anterior communicating aneurysm
Ruptured aneurysm
Endovascular intervention
Complications
Prognosis
