WEB瘤内扰流装置治疗颅内复杂动脉瘤的疗效及对预后的影响  

Efficacy of the Woven EndoBridge Device in the treatment of complex intracranial aneurysms and its impact on prognosis

作　　者：李光辉[1] 徐浩文[2] 范峰 刘朝[2] 李文燕 郭园园[1] 李朝阳 LI Guang-hui;XU Hao-wen;FAN Feng;LIU Zhao;LI Wen-yan;GUO Yuan-yuan;LI Zhao-yang(Emergency Interventional Operation Room,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Neurointervention,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院急诊介入手术室,河南郑州450000 [2]郑州大学第一附属医院神经介入科,河南郑州450000

出　　处：《海南医学》2025年第6期773-779,共7页Hainan Medical Journal

基　　金：2022横向项目(编号:2022-hx-36)。

摘　　要：目的探讨瘤内扰流装置(WEB)治疗颅内复杂动脉瘤的疗效及对预后的影响。方法选取2022年1月至2024年1月郑州大学第一附属医院收治的102例颅内复杂动脉瘤患者作为研究对象,按随机数表法分为观察组和对照组各51例。对照组患者行支架辅助弹簧圈栓塞术,观察组患者行WEB装置介入栓塞术。术后采用血管CT(VasoCT)观察两组患者的支架贴壁情况、动脉瘤栓塞程度,比较两组患者手术前后脑血流动力学(动脉瘤颈、载瘤动脉、患侧大脑中动脉的血流速度)、预后[改良Rankin评分(mRs)、神经功能缺损量表(NFD)评分、日常生活活动能力评分(ADL)],并比较两组患者住院期间的并发症发生率。结果观察组患者术后即刻动脉瘤栓塞程度占比分别为A级29.41%、B级37.25%、C级25.49%、D级7.84%,优于对照组患者的A级19.61%、B级27.45%、C级29.41%、D级23.53%,术后6个月分别为A级36.00%、B级42.00%、C级22.00%、D级0.00%,优于对照组的A级24.49%、B级30.61%、C级32.65%、D级12.24%,差异均有统计学意义(P<0.05);术后1 d,观察组患者的动脉瘤颈血流速度为(13.65±2.47)cm/s,明显低于对照组的(15.73±3.10)cm/s,载瘤动脉、患侧大脑中动脉血流速度分别为(118.32±9.13)cm/s、(100.64±8.24)cm/s,明显高于对照组的(110.58±7.84)cm/s、(94.79±6.65)cm/s,差异均有统计学意义(P<0.05);术后6个月,观察组患者的mRs、NFD评分分别为(0.68±0.10)分、(7.03±0.53)分,明显低于对照组的(1.04±0.15)分、(7.75±0.61)分,ADL评分为(85.21±3.31)分,明显高于对照组的(80.37±4.02)分,差异均有统计学意义(P<0.05);观察组患者的住院期间并发症发生率为3.92%,明显低于对照组的17.65%,差异有统计学意义(P<0.05)。结论通过VasoCT观察WEB装置介入栓塞治疗颅内复杂动脉瘤发现其可获得良好完全栓塞效果,且有效改善大脑血流动力学参数,利于术后神经功能恢复,减轻残障程度,提高生活能力。Objective To investigate the efficacy of Woven EndoBridge(WEB)device in the treatment of complex intracranial aneurysms and its impact on prognosis.Methods A total of 102 patients with complex intracranial aneurysms admitted to the First Affiliated Hospital of Zhengzhou University from January 2022 to January 2024 were randomized into an observation group(n=51)and a control group(n=51).Patients in the control group underwent stent-assisted coil embolization,while those in the observation group received WEB device embolization.After the operation,vascular CT(VasoCT)was performed to observe the stent apposition and the degree of aneurysm embolisation in both groups.The cerebral hemodynamics(blood flow velocity of the aneurysm neck,parent artery,and affected middle cerebral artery)and prognosis(modified Rankin scale[mRs],Neurological Function Deficit Scale[NFD]score,and Activities of Daily Living(ADL)scale)were compared between the two groups before and after surgery.The incidence of complications during hospitalization was also compared.Results The proportions of patients in the observation group with immediate aneurysm embolization after surgery were 29.41%for grade A,37.25%for grade B,25.49%for grade C,and 7.84%for grade D,which were superior to the control group's proportions of 9.61%(grade A),27.45%(grade B),29.41%(grade C),and 23.53%(grade D).Six months after surgery,the proportions were 36.00%for grade A,42.00%for grade B,22.00%for grade C,and 0.00%for grade D,which were superior to the control group's 24.49%(grade A),30.61%(grade B),32.65%(grade C),and 12.24%(grade D);the differences were statistically significant(P<0.05).One day after surgery,the blood flow velocity of the aneurysm neck in the observation group was(13.65±2.47)cm/s,which was significantly lower than(15.73±3.10)cm/s in the control group;the blood flow velocity of the parent artery and the affected middle cerebral artery were(118.32±9.13)cm/s and(100.64±8.24)cm/s,respectively,which were significantly higher than(110.58±7.84)cm/s and(94.79

关 键 词：颅内复杂动脉瘤 锥形束CT WEB装置 神经功能 预后 并发症 

分 类 号：R739.41[医药卫生—肿瘤]