中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
14期
29-31
,共3页
颅内动脉瘤%破裂%危险因素%电解可脱式弹簧圈
顱內動脈瘤%破裂%危險因素%電解可脫式彈簧圈
로내동맥류%파렬%위험인소%전해가탈식탄황권
Intracranial aneurysm%Rupture%Risk factors%Guglielmi detachable coil
目的 探讨颅内动脉瘤在电解可脱式弹簧圈(GDC)栓塞术中发生破裂的危险因素及处理方法.方法 2000年8月至2010年6月,以GDC栓塞术治疗420例动脉瘤性蛛网膜下隙出血(SAH)患者,对其临床资料进行回顾性总结,统计分析颅内动脉瘤在GDC栓塞术中发生破裂的危险因素.结果 共16例术中发生动脉瘤破裂,发生率为3.8%(16/420),术后13例致密填塞,3例部分填塞.单因素分析显示:SAH发作次数≥2次、瘤体≤4 mm、有假性动脉瘤、Hunt-Hess分级为Ⅳ～Ⅴ级、有高血压病史以及瘤颈窄是引起颅内动脉瘤GDC栓塞术中发生破裂的危险因素.多因素 Logistic回归分析显示:SAH发作次数≥2次(P=0.0424,OR=6.798)以及有假性动脉瘤(P=0.0069,OR=4.423)是引起颅内动脉瘤GDC栓塞术中发生破裂的独立危险因素.结论 颅内动脉瘤在GDC栓塞术中发生破裂主要与SAH多次发作以及存在假性动脉瘤有关,临床上对存在危险因素者应警惕发生术中破裂,一旦发生应积极给予合理的治疗,大多数患者能获得良好预后.
目的 探討顱內動脈瘤在電解可脫式彈簧圈(GDC)栓塞術中髮生破裂的危險因素及處理方法.方法 2000年8月至2010年6月,以GDC栓塞術治療420例動脈瘤性蛛網膜下隙齣血(SAH)患者,對其臨床資料進行迴顧性總結,統計分析顱內動脈瘤在GDC栓塞術中髮生破裂的危險因素.結果 共16例術中髮生動脈瘤破裂,髮生率為3.8%(16/420),術後13例緻密填塞,3例部分填塞.單因素分析顯示:SAH髮作次數≥2次、瘤體≤4 mm、有假性動脈瘤、Hunt-Hess分級為Ⅳ～Ⅴ級、有高血壓病史以及瘤頸窄是引起顱內動脈瘤GDC栓塞術中髮生破裂的危險因素.多因素 Logistic迴歸分析顯示:SAH髮作次數≥2次(P=0.0424,OR=6.798)以及有假性動脈瘤(P=0.0069,OR=4.423)是引起顱內動脈瘤GDC栓塞術中髮生破裂的獨立危險因素.結論 顱內動脈瘤在GDC栓塞術中髮生破裂主要與SAH多次髮作以及存在假性動脈瘤有關,臨床上對存在危險因素者應警惕髮生術中破裂,一旦髮生應積極給予閤理的治療,大多數患者能穫得良好預後.
목적 탐토로내동맥류재전해가탈식탄황권(GDC)전새술중발생파렬적위험인소급처리방법.방법 2000년8월지2010년6월,이GDC전새술치료420례동맥류성주망막하극출혈(SAH)환자,대기림상자료진행회고성총결,통계분석로내동맥류재GDC전새술중발생파렬적위험인소.결과 공16례술중발생동맥류파렬,발생솔위3.8%(16/420),술후13례치밀전새,3례부분전새.단인소분석현시:SAH발작차수≥2차、류체≤4 mm、유가성동맥류、Hunt-Hess분급위Ⅳ～Ⅴ급、유고혈압병사이급류경착시인기로내동맥류GDC전새술중발생파렬적위험인소.다인소 Logistic회귀분석현시:SAH발작차수≥2차(P=0.0424,OR=6.798)이급유가성동맥류(P=0.0069,OR=4.423)시인기로내동맥류GDC전새술중발생파렬적독립위험인소.결론 로내동맥류재GDC전새술중발생파렬주요여SAH다차발작이급존재가성동맥류유관,림상상대존재위험인소자응경척발생술중파렬,일단발생응적겁급여합리적치료,대다수환자능획득량호예후.
Objective To investigate the risk factors and treatment experience of cerebral aneurysms rupture in the course of Gugliemi detachable coil (GDC) embolization. Methods From August 2000 to June 2010,420 patients with aneurysmal subarachnoid hemorrhage (SAH) received GDC embolization and their clinical data were retrospectively reviewed to analyse the risk factors of cerebral aneurysms rupture in the course of treatment. Results Sixteen patients had intraoperative aneurysm rupture, the incidence rate was 3.8%(16/420),including 13 cases density filling,3 cases partial filling postoperative.Univariate analysis showed:SAH episodes ≥2 times,tumor size ≤4 mm,the presence of pseudoaneurysm,Hunt-Hess grade Ⅳ - Ⅴ as well as history of hypertension were the risk factors of cerebral aneurysms rupture in the course of GDC embolization. Logistic regression analysis showed:SAH episodes ≥2 times (P = 0.0424,OR =6.798)and the presence of pseudoaneurysm (P = 0.0069, OR = 4.423) were the independent risk factors of cerebral aneurysms rupture. Conclusions Rupture of intracranial aneurysm in the course of GDC embolization is mainly related to the multiple SAH and the presence of pseudoaneurysm. It should be alert to the risk factors and take active treatment as soon as the occurrence of rupture in clinic work, for this, most patients can get a good prognosis.
