动脉瘤介入栓塞术后非原动脉瘤部位血管破裂出血临床分析  

Clinical analysis of perioperative cerebral intraparenchymal hemorrhage unrelated to rerupture of aneurysm following coil embolization of intracranial aneurysms

作　　者：杨与敏[1] 梁小龙 龙晓东[1] 叶峰 邹林波[1] 刘之彝[1] 李爱国[1] YANG Yumin;LIANG Xiaolong;LONG Xiaodong;YE Feng;ZOU Linbo;LIU Zhiyi;LI Aiguo(Department of Neurosurgery,People's Hospital of Deyang city,Deyang 618000,China)

机构地区：[1]德阳市人民医院神经外科,德阳618000

出　　处：《中国神经精神疾病杂志》2020年第10期582-586,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：德阳市科技计划项目(编号:2019sz111)。

摘　　要：目的探讨颅内动脉瘤介入栓塞术后围手术期非原动脉瘤部位血管破裂出血患者的临床特点。方法回顾性分析我院497例确诊颅内动脉瘤并行介入栓塞治疗患者的临床资料,其中非原动脉瘤部位血管破裂出血患者12例(2.41%),未出血患者485例(97.59%)。比较两组导致非原动脉瘤部位血管破裂出血的可疑危险因素的暴露情况。结果497例患者中12例(2.41%)发生围手术期非原动脉瘤部位血管破裂出血,出血均发生在术后15 d以内,出血患者中3例(25%)出现严重神经功能障碍。介入栓塞术后围手术期非原动脉瘤部位血管破裂出血发生率:多支架并双抗患者出血发生率最高(16.67%),依次为单支架并双抗患者(2.89%)、单纯弹簧圈栓塞患者(0.50%),差异有统计学意义(P=0.002);未破裂动脉瘤患者出血发生率高于破裂动脉瘤患者(χ^2=7.178,P=0.007)。结论置入支架合并双抗治疗患者易发生非原动脉瘤部位血管破裂出血。Objective To investigate the clinical characteristics of perioperative cerebral intraparenchymal hemorrhage(cIPH)unrelated to rerupture of aneurysm following coil embolization of intracranial aneurysms.Methods A retrospective analysis of clinical data of 497 patients with intracranial aneurysms after coil embolization.Twelve patients(2.41%)developed perioperative cIPH.The risk factors were compared between the two groups.Results Twelve patients(2.41%)had perioperative cIPH unrelated to rerupture of aneurysm following coil embolization of intracranial aneurysms of 497 patients.All occurred within 15 days of treatment,three patients(25%)had major neurologic morbidity.The incidence of perioperative cIPH unrelated to rerupture of aneurysm was 16.67% in patients underwent multi-stent-assisted coiling and dual antiplatelet therapy,2.89% in patients underwent Stent-assisted coiling and dual antiplatelet therapy and 0.50% in patients underwent coiling without stent.There were statistically significant differences in the incidence among the three groups(P=0.002).The incidence of perioperative cIPH unrelated to rerupture of aneurysm was significantly higher in patients with unruptured aneurysm than in patients with ruptured aneurysm(χ^2=7.178,P=0.007).Conclusion Our findings suggest that patients with stent-assisted coiling and dual antiplatelet therapy tend to have a higher risk of perioperative cIPH unrelated to rerupture of aneurysm.

关 键 词：颅内动脉瘤 栓塞 出血 并发症 

分 类 号：R651[医药卫生—外科学]