新型远距离与常规注射Onyx栓塞颅内动静脉畸形的对比研究  

A comparative study of onyx embolization in patients with with intracranial arteriovenous malformations: distant injection method versus routine method

作　　者：张龙[1,2] 何小艳[1] 漆松涛[1] 李伟光[1] 张国忠[1] 王刚[1] 李明洲[1] 冯文峰[1] 

机构地区：[1]南方医科大学南方医院神经外科 [2]粤北人民医院神经外科,韶关512026

出　　处：《中国神经精神疾病杂志》2013年第6期321-325,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：南方医科大学南方医院院长基金项目(编号:2012H002)

摘　　要：目的对比采用新型远距离与常规注射Onyx方法栓塞颅内动静脉畸形(arteriovenous malformations,AVMs)的疗效、安全性、注胶时间和射线暴露量。方法回顾性分析采用Onyx栓塞治疗的63例颅内AVMs的临床资料,分为新方法组31例,对照组32例。主要观察指标为:颅内AVMs大小,患者与术者射线暴露量,注胶时间,栓塞效果和并发症发生率。结果新方法组术者每次手术接受剂量当量(158.63μSv±49.71μSv)较对照组(212.96μSv±82.52μSv)少(t=-3.153,P=0.003)。颅内AVMs大小,注胶时间,颅内AVMs缩小率和并发症发生率两组间比较差异均无统计学意义(5.07cm±2.41cm比5.04cm±2.26cm,t=0.041,P=0.968;62.39min±25.61min比53.34min±29.58min,t=1.295,P=0.200;61.48%±26.86%比55.31%±26.10%,t=0.925,P=0.359;2例比4例,χ2=0.151,P=0.698)。结论采用新型远距离注射Onyx方法栓塞治疗颅内AVMs初步证实安全可行、疗效显著,可显著减少术者射线暴露量且不增加并发症。Objective To compare the efficacy, safety, injecting time and radiation exposure of Onyx embolization using a new distant injection method versus using routine method in patients with intracranial arteriovenous malforma- tions （AVMs）. Methods The clinical data of 63 patients with AVMs, in which 31 patients received onyx embolization with a distant injection and 32 with the routine method were retrospectively analyzed. Primary objective endpoints were the size of AVMs, radiation exposure of patients and surgeon, injecting time, volume reduction of AVMs and the inci- dence of complication. Results The average dose equivalent exposure to the surgeon per procedure was smaller in the new distant injection method than in routine method （158.63μSv±49.7μSv vs. 212.96μSv±82.52μSv; t=-3.153, P=- 0.003）. There were no significant differences between two methods in the size of AVMs, injecting time, volume reduction of AVMs and the incidence of complication （5.07cm±2.41cm vs. 5.04cm±2.26cm ,t=0.041, t=-0.968; 62.39min±25.61min vs. 53.34min±29.58min, t=-1.295, P=0.200; 61.48%±26.86% vs.55.31%±26.10%,t=0.925, P=0.359; 2 cases vs. 4 cases, χ^2=0.151, P=0.698）. Conclusions Endovascular treatment of intracranial AVMs with Onyx embolization using this new distant injection method is feasible, safe and effective. The method minimizes potential radiation exposure to the surgeon without increasing surgical complications.

关 键 词：远距离注射 ONYX 颅内动静脉畸形 栓塞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]