伴子囊颅内囊状动脉瘤单纯血管内栓塞术后瘤颈残留复发的危险因素  

The risk factors for recurrence of neck-remnant intracranial saccular aneurysms with bleb after simple intravascular embolization

作　　者：张磊 万军 蒋业清[2] 张晓龙[2] ZHANG Lei;WAN Jun;JIANG Yeqing(Department of Interventional Radiology,Jing′an District Central Hospital,Shanghai 200040,CHINA)

机构地区：[1]上海市静安区中心医院(复旦大学附属华山医院静安分院)放射介入科,200040 [2]复旦大学附属华山医院放射介入科

出　　处：《江苏医药》2021年第8期767-771,共5页Jiangsu Medical Journal

基　　金：国家自然科学基金(81771242)。

摘　　要：目的分析伴子囊颅内囊状动脉瘤(ISA)单纯弹簧圈血管内栓塞术后瘤颈残留复发的危险因素。方法回顾性分析98例伴子囊ISA单纯血管内栓塞术后即刻瘤颈残留患者的临床资料,根据DSA影像学随访结果将患者分为复发组(37例)和稳定组(61例)。采用单因素和多因素logistic回归分析复发相关的危险因素。结果单因素分析结果表明,两组患者年龄、ISA破裂与否、瘤径大小、血管分叉部和RaymondⅡ级亚型的差异均有统计学意义(P<0.05)。多因素logistic回归分析结果表明,年龄大(OR=5.140)、ISA破裂(OR=1.831)、术后RaymondⅡc型(OR=3.758)、ISA大(OR=4.623)和血管分叉部(OR=2.257)是伴子囊ISA单纯血管内栓塞术后瘤颈残留复发的独立危险因素(P<0.05)。结论年龄大、ISA大、ISA破裂、术后RaymondⅡc型和血管分叉部的伴子囊ISA单纯血管内栓塞术后瘤颈残留患者复发的风险增加。Objective To analyze the risk factors for the recurrence of neck-remnant intracranial saccular aneurysms with bleb after simple coil intravascular embolization.Methods The clinical data of 98 patients with neck-remnant intracranial saccular aneurysms with bleb after simple intravascular embolization were retrospectively analyzed, who were divided into two groups of A(with recurrence, 37 cases) and B(without recurrence, 61 cases) according to the results of DSA imaging follow-up.Univariate and multivariate logistic regression were used to analyze the risk factors for the recurrence of aneurysms.Results Univariate analysis showed that there were significant differences in age, aneurysm rupture, aneurysm diameter, vascular bifurcation and Raymond Ⅱ subtype between the two groups(P<0.05).Multivariate logistic regression analysis showed that older age(OR=5.140),aneurysm rupture(OR=1.831),Raymond Ⅱc after operation(OR=3.758),larger aneurysm(OR=4.623) and vascular bifurcation(OR=2.257) were the independent risk factors for the recurrence of neck-remnant intracranial saccular aneurysms with bleb after simple intravascular embolization.Conclusion Older age, larger aneurysm, ruptured aneurysm, Raymond Ⅱc after operation and vascular bifurcation are the independent risk factors for predicting aneurysm recurrence of the patients with neck-remnant intracranial saccular aneurysms with bleb after simple intravascular embolization.

关 键 词：颅内囊状动脉瘤 血管内栓塞术 复发 

分 类 号：R732[医药卫生—肿瘤]