摘要
目的观察介入栓塞治疗颅内动脉瘤所致动眼神经麻痹的临床疗效及影响因素。方法回顾性分析连续行介入栓塞治疗动脉瘤所致的动眼神经麻痹患者的临床资料,共18例。分析动眼神经麻痹恢复情况与术前麻痹程度(完全、不完全)、发病至治疗时间(≤14 d、>14 d)、动脉瘤大小(≤7 mm、>7 mm)、术前有无出血及栓塞致密程度(完全、瘤颈残留)的关系。所有患者术后均获24个月随访。结果①18例患者均栓塞成功,12例完全栓塞,6例瘤颈残留。②18例患者动眼神经麻痹完全恢复11例(11/18),不完全恢复6例(6/18),总改善率为94.4%(17/18);1例动脉瘤复发患者症状无改善。③术前动眼神经麻痹程度、发病至治疗时间、动脉瘤大小、有无蛛网膜下腔出血、栓塞程度对动眼神经麻痹恢复的影响差异无统计学意义(均P>0.05)。结论动脉瘤栓塞术可以有效恢复动脉瘤所致的动眼神经麻痹,无改善者须考虑动脉瘤是否再通。
Objective To observe the clinical efficacy and influencing factors of interventional intracranial aneurysm embolization-indueed oculomotor nerve palsy. Methods The clinical data of 18 consecutive patients with intracranial aneurysmembolization-indueed oculomotor nerve palsy were analyzed retrospectively. The relationships between the recovery of oculomotor palsy and the degree of preoperative palsy （complete, incomplete）, time from onset to treatment （≤ 14d, 〉 14d） , size of aneurism （ ≤7mm, 〉 7mm） , with or without preoperative hemorrhage, and the compactness of embolization （complete, residual neck） were analyzed. All the patients were followed up for 24 months. Results （1）All the aneurysms of 18 patients were embolized successfully. The aneurysms of the 12 patients were embolized completely, and 6 had residual necks. （2）The oculomotor palsy in 11 of the 18 patients recovered completely, 6 recovered partially. The total improving rate was 94. 4% ; one patient with recurrence of the aneurysm did not showed any improvement. （3）There were no significant differences in the seriousness of preoperative oculomotor palsy, time from onset to treatment, size of aneurysm, with or without subarachnoid hemorrhage, and compactness of embolization on the recovery of oculomotor nerve palsy （ all P 〉 0. 05 ）. Condusion Aneurysm embolization may effectively improve aneurysm-induced oculomotor palsy. If no any improvement after embolization, recanalization of the aneurysm should be considered.
出处
《中国脑血管病杂志》
CAS
2010年第8期432-435,共4页
Chinese Journal of Cerebrovascular Diseases
关键词
颅内动脉瘤
动眼神经疾病
栓塞
治疗性
预后
Intracranial aneurysm
Oculomotor nerve diseases
Embolization, therapeutic
Prognosis
