血管内介入治疗周围型颅内动脉瘤预后因素分析  

Analysis of prognostic factors in peripheral intracranial aneurysms with intravascular interventional therapy

作　　者：黄焱明 刘天庆 祁小龙 Huang Yanming,Liu Tianqing,Qi Xiaolong(Department of Neurosurgery, Longyan First Hospital of Fujian Medical University, Longyan 364000, Fujian, Chin)

机构地区：[1]福建医科大学附属龙岩第一医院神经外科,福建龙岩364000

出　　处：《血管与腔内血管外科杂志》2017年第4期867-870,879,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的分析血管内介入治疗周围型颅内动脉瘤预后的相关影响因素。方法回顾性研究2011年4月至2015年4月在福建医科大学附属龙岩第一医院接受血管内介入治疗的60例周围型颅内动脉瘤患者的临床资料。根据患者相关影像学资料和术后随访结果,判断动脉瘤复发和神经功能改善的情况,分析动脉瘤复发和神经功能改善的相关影响因素。结果术后随访2年,在60例患者中动脉瘤复发8例,神经功能改善不良10例,部分栓塞患者的动脉瘤复发率高于完全栓塞患者,夹层动脉瘤患者的动脉瘤复发率高于囊状动脉瘤患者,差异有统计学意义(P<0.05);在神经功能改善不良患者中合并高血压、脑积水、动脉瘤直径≤15 mm和Hunt-Hess分级Ⅳ级的患者比例高于神经功能改善良好患者,差异有统计学意义(P<0.05)。结论周围型颅内动脉瘤患者实施血管内介入治疗安全有效,部分栓塞和夹层动脉瘤是患者术后动脉瘤复发的主要影响因素,而合并高血压、脑积水、动脉瘤直径≤15 mm和Hunt-Hess分级Ⅳ级均是导致患者神经功能改善不良的主要影响因素,其中合并脑积水为独立危险因素。Objective To analyze the related factors influencing the prognosis of peripheral intracranial aneurysms. Methods The clinical data of 60 patients with peripheral intracranial aneurysms were studied from April 2011 to April 2015 in Longyan First Hospital of Fujian Medical University. According to the related imaging data and postoperative followup results of patients, the diagnosis of aneurysm relapse and the improvement of neurological function were determined, and the related factors affecting the recurrence of aneurysm and the improvement of neurological function were analyzed. Results During 2 years of postoperative follow-up of 60 patients with aneurysms, 8 patients had aneurysm recurrence, the improvement of neurological function was not good in 10 patients, the aneurysms recurrence rate of patients with partial embolization was higher than that of patients with completely embolism, dissecting aneurysm recurrence rate was higher than saccular aneurysm recurrence rate, the difference was statistically significant（P〈0.05）. The proportions of hypertension, hydrocephalus, aneurysm diameter 15 mm or less and Hunt-Hess class Ⅳ in patients with neurological function to improve adverse were higher than those in patients with neurological function to improve good, the difference was statistically significant（P〈0.05）. Conclusions Endovascular interventional therapy is safe and effective for patients with peripheral intracranial aneurysm, the main influencing factors of postoperative aneurysm recurrence are partial embolization and dissecting aneurysm, and hypertension, hydrocephalus, aneurysm diameter 15 mm or less and Hunt-Hess class Ⅳ are lead to improvement of nerve function in patients with adverse factors, including merger hydrocephalus as independent risk factors.

关 键 词：周围型颅内动脉瘤 血管内介入治疗 动脉瘤复发 神经功能改善 

分 类 号：R732.21[医药卫生—肿瘤]