后交通动脉瘤性动眼神经麻痹术后恢复的相关因素分析

赵青; 汤阳阳; 李顺; 邱大志; 谢满意; 王强; 李中林

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后交通动脉瘤性动眼神经麻痹术后恢复的相关因素分析

临床研究 | 更新时间：2023-05-22

- 后交通动脉瘤性动眼神经麻痹术后恢复的相关因素分析
- Analysis on factors of postoperative recovery of oculomotor nerve palsy caused by posterior communicating artery aneurysm
- 局解手术学杂志 2019年第5期页码：369
- 作者机构：
  
  徐州医科大学附属医院神经外科
- 作者简介：
- 基金信息：
- DOI：
  中图分类号：
- 纸质出版日期：2019，
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赵青, 汤阳阳, 李顺, 等. 后交通动脉瘤性动眼神经麻痹术后恢复的相关因素分析[J]. 局解手术学杂志, 2019,(5):369.

ZHAO Qing, TANG Yangyang, LI Shun, et al. Analysis on factors of postoperative recovery of oculomotor nerve palsy caused by posterior communicating artery aneurysm[J]. null, 2019,(5):369.
赵青, 汤阳阳, 李顺, 等. 后交通动脉瘤性动眼神经麻痹术后恢复的相关因素分析[J]. 局解手术学杂志, 2019,(5):369. DOI：

ZHAO Qing, TANG Yangyang, LI Shun, et al. Analysis on factors of postoperative recovery of oculomotor nerve palsy caused by posterior communicating artery aneurysm[J]. null, 2019,(5):369. DOI：

摘要

目的探讨后交通动脉瘤性动眼神经麻痹患者手术治疗后动眼神经麻痹症状的恢复情况，并对临床上可能影响其恢复的相关因素进行分析。方法回顾性分析徐州医科大学附属医院2014年12月至2018年7月收治的伴有动眼神经麻痹的54例后交通动脉瘤患者的临床资料，所有患者术后随访3个月以上，评价动眼神经麻痹症状的预后情况。结果 54例患者中，行开颅动脉瘤夹闭术39例，血管内动脉瘤栓塞术15例。单因素分析结果显示，手术时机小于等于14 d的患者动眼神经麻痹预后优于大于14 d的患者，差异有统计学意义（P=0.007）；术前动眼神经部分麻痹患者预后优于完全麻痹患者，差异有统计学意义（P=0.003），患者年龄、动脉瘤侧别、动脉瘤大小、动脉瘤出血与否和手术方式等与患者动眼神经麻痹预后无关（P＞0.05）。多因素Logistic分析结果显示，手术时机和术前动眼神经麻痹程度是影响后交通动脉瘤性动眼神经麻痹患者动眼神经麻痹预后的独立因素（OR=21.528，95%CI：1.769~261.990，P=0.016；OR=28.040，95%CI：2.623~299.718，P=0.006）。结论开颅动脉瘤夹闭术与血管内动脉瘤栓塞术都是后交通动脉瘤性动眼神经麻痹的有效治疗方式，术前动眼神经部分麻痹的患者和早期手术治疗的患者恢复相对较好。

Abstract

Objective To investigate the recovery of oculomotor palsy symptoms in patients with posterior communicating aneurysmal oculomotor palsy after treatment

the related factors that may affect the recovery of oculomotor palsy were analyzed.Methods of The clinical data of 54 patients with posterior communicating artery aneurysm with oculomotor nerve palsy admitted to affiliated hospital of Xuzhou medical university from December 2014 and July of 2018 were retrospectively analyzed.All patients were followed up for 3 months or more after surgery to evaluate the prognosis of oculomotor nerve palsy.Results Among 54 patients

39 cases were treated by craniotomy clipping

and 15 cases were treated by intravascular embolization.The results of univariate analysis showed that the prognosis of the patients with operation timing≤14 days was significantly better than that of patients with operation timing＞14 days

and the difference was statistically significant(P=0.007);the prognosis of patients with partial paralysis of oculomotor nerve before operation was better than that of patients with complete paralysis

the difference was statistically significant(P=0.003); the patient′s age

aneurysm side

aneurysm size

aneurysm hemorrhage

and surgical procedure were unrelated to the prognosis of oculomotor palsy symptoms (P＞0.05).Multiple logistic regression analysis result showed that operation timing and preoperative oculomotor nerve palsy degree were the independent prognostic influencing factors of oculomotor palsy symptoms(OR=21.528，95%CI：1.769~261.990，P=0.016；OR=28.040，95%CI：2.623~299.718，P=0.006).Conclusion Both craniotomy clipping and intravascular embolization are effective treatments for posterior communicating artery 〖JP〗aneurysmrelated oculomotor nerve palsy

the prognosis of preoperative part oculomotor nerve palsy patients and patients with early surgical treatment is relatively better.

关键词

后交通动脉瘤动眼神经麻痹预后相关因素开颅夹闭介入栓塞

Keywords

posterior communicating artery aneurysmoculomotor nerve palsyprognosisinfluencing factorssurgical clippingendovascular embolization

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