摘要
目的比较颅内未破裂的小型动脉瘤(最大直径≤5 mm)和中大型动脉瘤的介入栓塞治疗效果。方法回顾性分析我科2011年6月至2014年8月收治的颅内未破裂动脉瘤54例,根据动脉瘤直径大小不同将其分为2组:小型动脉瘤组16例(最大直径≤5 mm)和中大型动脉瘤组38例。患者均行介入栓塞治疗,出院后3个月通过门诊及电话随访,出院后6个月通过我科DSA随访,比较两组栓塞率、并发症发生率、复发率等。结果 1小型动脉瘤组16例(100%)完全栓塞,13例(81.3%)支架辅助弹簧圈栓塞,中大型动脉瘤组36例(92.1%)完全栓塞,24例(63.2%)支架辅助弹簧圈栓塞,小型动脉瘤组完全栓塞率稍高,但差异无统计学意义(P>0.05);2小型动脉瘤组2例(12.5%)发生脑血管痉挛,中大型动脉瘤组5例(15.8%)发生脑血管痉挛,1例(2.6%)发生术中动脉瘤破裂,小型动脉瘤组并发症发生率稍低,但差异无统计学意义(P>0.05);3小型动脉瘤组14例(87.5%)恢复良好,11例(68.8%)DSA随访示无复发;大型动脉瘤组30例(78.9%)恢复良好,26例(68.4%)DSA随访示3例(7.9%)复发,小型动脉瘤组良好预后率稍高,复发率稍低,但差异无统计学意义(P>0.05)。结论颅内未破裂的小型动脉瘤和中大型动脉瘤采取介入栓塞治疗效果均较好。
Objective To compare the outcomes of embolization in the treatment of intracranial unruptured small aneurysms（ diameter ≤5 mm） and medium-large aneurysms. Methods Fifty-four patients with intracranial un-ruptured aneurysms admitted in our department from June 2011 to August 2014 were enrolled in this study. According to the diameter of aneurysms,they were divided into small aneurysms group（ diameter ≤5 mm,n = 16） and medium-large aneurysms group（ diameter 〉5 mm,n = 38）. All patients received interventional embolization. They were followed up in our clinic or through telephone in 3 months after being discharged,and examined through digital subtraction angiography（ DSA） in 6 months after dehospitalization. The rates of embolization,complications and recurrence were compared between the 2groups. Results（ 1） In the small aneurysms group,16 cases（ 100%） were completely embolized,and 13cases（ 81. 3%） were by stent assisted coil,while 36 cases（ 92. 1%） from the medium-large aneurysms group obtained complete embolization,and 24 cases（ 63. 2%） were embolized by stent assisted coil. Complete embolization rate was higher in the small aneurysms group,with no statistical significance compared with the other group（ P 0. 05）.（ 2） Symptomatic cerebral vasospasm was found in 2 cases（ 12. 5%） in the small aneurysms group,and in 5 cases（ 15. 8%） from the medium-large aneurysms group. Intraoperative aneurysm rupture occurred in 1 patient（ 2. 6%） from the medium-large aneurysms group. The incidence of complications was slightly lower in the small aneurysms group,but there was no statistical significance with the other group（ P 0. 05）.（ 3） In the small aneurysms group,14 cases（ 87. 5%） recovered well,and 11（ 68. 8%） were identified without show of recurrence by DSA. And in the medium-large aneurysms group,30patients（ 78. 9%） recovered well,however,3 cases（ 7. 9%） was found recurrence among all the 26 cases（ 68. 4%） receiving follow-up DSA. Thus,small aneurysms group showed better prognosis and lower recurrence rate,though with no statistical significance（ P 0. 05）. Conclusion Interventional embolization treatment has good curative effect for intracranial un-ruptured small and medium-large aneurysms.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2016年第3期288-291,306,共5页
Journal of Third Military Medical University
基金
国家自然科学基金青年科学基金(81100865)
国家临床重点专科建设经费资助项目([2011]170号)~~
关键词
未破裂
颅内动脉瘤
治疗性栓塞
un-rupture
small aneurysm
embolization
efficacy
