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纸质出版:2016
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郑鉴峰,张晓冬,郭宗铎,朱继,何朝晖,黄钦江,孙晓川.介入栓塞治疗小型与中大型颅内未破裂动脉瘤的效果对比[J].陆军军医大学学报(原第三军医大学学报),2016,38(03):288-291.
Zheng Jianfeng,Zhang Xiaodong,Guo Zongduo,Zhu Ji,He Zhaohui,Huang Qingjiang,Sun Xiaochuan.Efficacy of embolization in treatment of small vs medium-large intracranial unruptured aneurysms: report of 54 cases[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(03):288-291.
郑鉴峰,张晓冬,郭宗铎,朱继,何朝晖,黄钦江,孙晓川.介入栓塞治疗小型与中大型颅内未破裂动脉瘤的效果对比[J].陆军军医大学学报(原第三军医大学学报),2016,38(03):288-291. DOI:
Zheng Jianfeng,Zhang Xiaodong,Guo Zongduo,Zhu Ji,He Zhaohui,Huang Qingjiang,Sun Xiaochuan.Efficacy of embolization in treatment of small vs medium-large intracranial unruptured aneurysms: report of 54 cases[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(03):288-291. DOI:
目的 比较颅内未破裂的小型动脉瘤(最大直径≤5 mm)和中大型动脉瘤的介入栓塞治疗效果。 方法 回顾性分析我科2011年6月至2014年8月收治的颅内未破裂动脉瘤54例,根据动脉瘤直径大小不同将其分为2组:小型动脉瘤组16例(最大直径≤5 mm)和中大型动脉瘤组38例。患者均行介入栓塞治疗,出院后3个月通过门诊及电话随访,出院后6个月通过我科DSA随访,比较两组栓塞率、并发症发生率、复发率等。 结果 ①小型动脉瘤组16例(100%)完全栓塞,13例(81.3%)支架辅助弹簧圈栓塞,中大型动脉瘤组36例(92.1%)完全栓塞,24例(63.2%)支架辅助弹簧圈栓塞,小型动脉瘤组完全栓塞率稍高,但差异无统计学意义(P0.05);②小型动脉瘤组2例(12.5%)发生脑血管痉挛,中大型动脉瘤组5例(15.8%)发生脑血管痉挛,1例(2.6%)发生术中动脉瘤破裂
小型动脉瘤组并发症发生率稍低,但差异无统计学意义(P0.05);③小型动脉瘤组14例(87.5%)恢复良好,11例(68.8%)DSA随访示无复发;大型动脉瘤组30例(78.9%)恢复良好,26例(68.4%)DSA随访示3例(7.9%)复发
小型动脉瘤组良好预后率稍高,复发率稍低,但差异无统计学意义(P0.05)。 结论 颅内未破裂的小型动脉瘤和中大型动脉瘤采取介入栓塞治疗效果均较好。
Objective To compare the outcomes of embolization in the treatment of intracranial un-ruptured small aneurysms (diameter ≤5 mm) and medium-large aneurysms. Methods Fifty-four patients with intracranial un-ruptured aneurysms admitted in our department from June 2011 to August 2014 were enrolled in this study. According to the diameter of aneurysms
they were divided into small aneurysms group (diameter ≤5 mm
n=16) and medium-large aneurysms group (diameter 5 mm
n=38). All patients received interventional embolization. They were followed up in our clinic or through telephone in 3 months after being discharged
and examined through digital subtraction angiography (DSA) in 6 months after dehospitalization. The rates of embolization
complications and recurrence were compared between the 2 groups. Results (1) In the small aneurysms group
16 cases (100%) were completely embolized
and 13 cases (81.3%) were by stent assisted coil
while 36 cases (92.1%) from the medium-large aneurysms group obtained complete embolization
and 24 cases (63.2%) were embolized by stent assisted coil. Complete embolization rate was higher in the small aneurysms group
with no statistical significance compared with the other group (P0.05). (2) Symptomatic cerebral vasospasm was found in 2 cases (12.5%) in the small aneurysms group
and in 5 cases (15.8%) from the medium-large aneurysms group. Intraoperative aneurysm rupture occurred in 1 patient (2.6%) from the medium-large aneurysms group. The incidence of complications was slightly lower in the small aneurysms group
but there was no statistical significance with the other group (P0.05). (3) In the small aneurysms group
14 cases (87.5%) recovered well
and 11 (68.8%) were identified without show of recurrence by DSA. And in the medium-large aneurysms group
30 patients (78.9%) recovered well
however
3 cases (7.9%) was found recurrence among all the 26 cases (68.4%) receiving follow-up DSA. Thus
small aneurysms group showed better prognosis and lower recurrence rate
though with no statistical significance (P0.05). Conclusion Interventional embolization treatment has good curative effect for intracranial un-ruptured small and medium-large aneurysms.
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