后交通动脉动脉瘤致动眼神经麻痹的预后分析  

Analysis of prognoses in patients with posterior communicating artery aneurysm-induced oculomotor nerve paresis

作　　者：顾大群[1] 张扬 晁迎九[1] 魏建军[1] 傅先明[1] 牛朝诗[1] 余舰[1] 

机构地区：[1]安徽医科大学附属省立医院神经外科,合肥230001

出　　处：《中国临床神经外科杂志》2014年第10期587-589,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨后交通动脉动脉瘤引起动眼神经麻痹(ONP)的预后影响因素。方法回顾性分析2009年1月至2013年12月收治的52例后交通动脉动脉瘤致ONP患者临床资料,血管内栓塞治疗33例,开颅手术治疗19例。结果术后ONP完全恢复25例(48.1%),部分恢复21例(40.4%),无变化6例(11.5%)。血管内栓塞33例中,ONP完全恢复15例,部分恢复14例,无变化4例;手术夹闭19例中,ONP完全恢复10例,部分恢复7例,无变化2例;两组患者疗效无显著差异(P>0.05)。术前动眼神经麻痹程度和ONP持续时间与术后动眼神经功能恢复显著相关(P<0.05)。结论血管内栓塞和手术夹闭对改善后交通动脉动脉瘤引起的ONP效果无显著差异;术前动眼神经部分麻痹和ONP持续时间短患者术后动眼神经功能完全恢复的可能性更大。Objective To investigate the prognoses in the patients with oculomotor nerve paresis （ONP） caused by posterior communicating artery （PComA） aneurysms and the factors related to the prognoses. Methods The clinical data of 52 patients with ONP caused hy PComA aneurysms, of whom, 19 underwent the microsurgery for elipping aneurysms and 33 endovascular embolization of the aneursms from January, 2009 to December, 2013, were analyzed retrospertively, Results The oculomotor nerve function were completely recovered in 95 patients, partly in 21 and unchanged in 6 after the treatment, Univariatc analyses showed that there was insignificant difference in the improved rate of oclulomotor nerve function betwcen the endovascular embolization and surgical clipping of the aneurvsms （P〉0.05）, and the degree and length of ONP before the treatment were related to the recovery of oculomotor nerve function after the treatment（P〉0.01）.Conclusions The improved rate of oculomotor nerve function after the endovascular embolization of the aneurysms is similar to thai of surgiral clipping of the aneurysms in the patients with ONP caused by PComA aneurysms. The patients with partial and short-term preoperative ONP caused by PComA aneurysms may easilier obtain complete recovery of oculomotor nerve function after the treatment.

关 键 词：后交通动脉动脉瘤 动眼神经麻痹 血管内治疗 显微手术 预后 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R747.9[医药卫生—临床医学]