介入栓塞治疗动脉瘤性蛛网膜下腔出血128例疗效观察  

Aneurysmal subarachnoid hemorrhage treated by interventional embolization clinical analysis of 128 cases

作　　者：周震远 罗祖炎[1] 李健[1] 杨建生[1] 陈书达[2] 楼林[2] 雷兵[2] 朱飚[2] 

机构地区：[1]浙江省人民医院/杭州医学院附属人民医院介入医学科,杭州310014 [2]浙江省人民医院/杭州医学院附属人民医院神经外科,杭州310014

出　　处：《浙江医学》2017年第9期727-730,共4页Zhejiang Medical Journal

摘　　要：目的评估介入栓塞治疗动脉瘤性蛛网膜下腔出血的临床疗效。方法回顾2014年10月至2016年10月128例介入栓塞治疗动脉瘤性蛛网膜下腔出血患者的临床资料,观察其临床治疗效果与预后情况。结果 128例患者(133个动脉瘤)中瘤腔完全栓塞93个(69.9%),次全栓塞37个(27.8%),不完全栓塞3个(2.3%)。窄颈动脉瘤次全栓塞和完全栓塞的比率明显高于宽颈动脉瘤,差异有统计学意义(P<0.05);治疗前生活质量评分(4.8±0.4)分,治疗后为(2.1±1.8)分,治疗前、后患者的生活质量评分比较差异有统计学意义(P<0.05),共死亡15例(11.3%),其中手术相关死亡1例(0.8%)。在急性期使用支架辅助栓塞动脉瘤12例(9.0%),术中支架内血栓形成1例(0.8%)。结论介入栓塞治疗动脉瘤性蛛网膜下腔出血疗效确切,手术创伤小,安全可靠。Objective To assess the clinical efficacy of interventional embolization for aneurysmal subarachnoid hemorrhage. Methods The clinical data of 128 patients with aneurysmal subarachnoid hemorrhage treated by interventional embolization in Zhejiang Provincial People's Hospital from October 2014 to October 2016 were retrospectively analyzed. Results Among 128 patients(133 aneurysms), there were complete occlusion in 93 cases(69.9%), sub-complete occlusion in 37 cases(27.8%) and incomplete occlusion in 3 cases(2.3%). The sub-complete and complete occlusion rates of narrow-neck aneurysms were higher than those of wide-neck aneurysms(P <0.05). The Modified Rankin Scale score of patients was decreased from(4.8 ±0.4) before the treatment to(2.1 ±1.8) after treatment(P <0.05). Fifteen patients died(11.3%), and one case was surgical-related death(0.8%). Twelve cases(9%)of aneurysms were treated with stent-assisted coiling in the acute phase, there was 1 case(0.8%)with intraoperative in-stent thrombosis. Conclusion Interventional embolization is effective, less traumatic, safe and reliable method for patients with aneurysmal subarachnoid hemorrhage.

关 键 词：动脉瘤 蛛网膜下腔出血 栓塞治疗 

分 类 号：R743.35[医药卫生—神经病学与精神病学]