瘤颈栓塞治疗颅内动脉瘤破裂的单臂研究  

Endovascular embolization of aneurysm for the treatment of intracranial aneurysm rupture

作　　者：李敏[1] 顾志强[1] 周朋利 李振东 高展 LI Min;GU Zhiqiang;ZHOU Pengli;LI Zhendong;GAO Zhan(The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院,河南郑州450014

出　　处：《中国实用神经疾病杂志》2018年第14期1530-1536,共7页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨动脉瘤颈部血管内弹簧圈栓塞术(ECE)治疗具有血泡形成颅内动脉瘤破裂(RICABF)的有效性和安全性。方法回顾性分析86例RICABF患者临床资料,包括继发性破裂/出血率,颈内动脉瘤栓塞率,残余/复发性动脉瘤,术中事件和栓塞后并发症,以及格拉斯哥结局量表(扩展)(GOS-E)的改善。结果动脉瘤完全闭塞72个(72/86,83.7%),颈部残留12个(12/86,14.0%),残留动脉瘤2个(2/86,2.3%)。术后GOS-E评分3分3例(3.5%),4分10例(11.6%),5分73例(84.9%)。所有患者行随访血管造影(平均9.0个月)。复发3例(3/86,3.5%)。没有报告提示动脉瘤破裂或出血。结论瘤颈部ECE是RICABF的有效且安全的治疗方式,其长期有效性和安全性需要在前瞻性和比较性研究中进行调查。Objective To investigate the efficacy and safety of intravascular intravascular coil embolization （ECE） in the treatment of aneurysm with rupture of intracranial aneurysm （RICABF）. Methods The clinical data of 86 patients with RICABF were retrospectively analyzed.Treatment prognosis included secondary rupture/bleeding rate,internal carotid aneurysm embolization rate,residual/recurrent aneurysm,intraoperative and post embolic complications,and improvement in the Glasgow Outcome Scale （GOS E）. Results The aneurysm was completely occluded in 72 （72/86,83.7%）,12 in the neck （12/86,14.0%）,and 2 residual aneurysms （2/86,2.3%）.The postoperative GOS E score was 3 points in 3 cases （3.5%）,4 points in 10 cases （11.6%）,and 5 points in 73 cases （84.9%）.All patients underwent follow up angiography （mean 9.0 months）.There were 3 cases of recurrence （3/86,3.5%）.No aneurysm rupture or bleeding was reported. Conclusion Mid term follow up studies have shown that tumor neck ECE is an effective and safe treatment for RICABF.The long term effectiveness and safety of this interventional radiology technique needs to be investigated in prospective and comparative studies.

关 键 词：颅内动脉瘤 破裂颅内动脉瘤 Bleb形成 假性动脉瘤 血管内栓塞 动脉瘤颈部栓塞 介入治疗 

分 类 号：R739.41[医药卫生—肿瘤]