介入栓塞治疗外伤性颈动脉海绵窦瘘的疗效分析  

Therapeutic effect of interventional embolization in traumatic carotid-cavernous fistula

作　　者：林超 常晗晓 沈瑜琪 李征 陈骅 刘宁 路华 Lin Chao;Chang Hanxiao;Shen Yuqi;Li Zheng;Chen Hua;Liu Ning;Lu Hua(Department of Neurosurgery,Jiangsu Province Hospital/the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]江苏省人民医院南京医科大学第一附属医院神经外科,南京210029

出　　处：《中国微侵袭神经外科杂志》2021年第8期355-358,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家自然科学基金青年项目(编号:81901258)。

摘　　要：目的探讨介入栓塞治疗外伤性颈动脉海绵窦瘘(traumatic carotid-cavernous fistula,TCCF)的疗效。方法回顾性分析97例TCCF病例资料,均接受介入栓塞治疗,其中球囊辅助弹簧圈或Onyx栓塞(球囊辅助组)58例,Willis覆膜支架栓塞(覆膜支架组)39例。结果与术前相比,术后颅内杂音、球结膜水肿和搏动性突眼恢复良好(恢复率均>80%)。两组病人眼球运动障碍术后恢复相对较差,球囊辅助组恢复率为53.33%(16/30),覆膜支架组为57.14%(12/21)。与球囊辅助组相比,覆膜支架组治疗费用较高(P<0.0001)、住院时间长(P=0.018),且出现颅内新发梗死灶7例(P=0.016)和非颅内出血6例(P=0.011)。结论介入栓塞是治疗TCCF的有效方法,但Willis覆膜支架围手术期并发症较高、住院费用多、住院时间长,不建议作为首选治疗方法。Objective To investigate the effect of interventional treatment for traumatic carotid-cavernous fistula(TCCF).Methods The clinical data of 97 patients with TCCF undergoing interventional embolization,including 58 with balloon-assisted coil or Onyx embolization(balloon-assisted group)and 39 with Willis covered stent embolization(stent-graft group),were retrospectively analyzed.Results Compared with preoperation,postoperative intracranial murmurs,bulbar conjunctival edema,and pulsating exophthalmos recovered well(recovery rates were all>80%).The recovery of eye movement disorde was relatively poor in the two groups.The recovery rate of the balloon-assisted group was 53.33%(16/30)and that of the stent-graft group was 57.14%(12/21).Compared with the balloon-assisted group,the stent-graft group had higher treatment costs(P<0.0001),longer hospital stay(P=0.018).In the stent-graft group,there was new intracranial infarction in 7 cases(P=0.016)and non-intracranial hemorrhage in 6(P=0.011).Conclusions Interventional embolization is an effective method for the treatment of TCCF,but the Willis covered stent has high perioperative complications,high hospitalization costs,and long hospital stay,so it is not recommended as the first choice of treatment.

关 键 词：颈动脉海绵窦瘘 颅脑损伤 介入治疗 预后 

分 类 号：R743.9[医药卫生—神经病学与精神病学]