CAJ | 학술논문

目的　比较机械可脱式弹簧圈(mechanical detachable spiral,MDS)与电解可脱式弹簧圈(Guglielmi detachable coil，GDC)囊内栓塞颅内动脉瘤。方法　对比分析1995年3月至1999年7月120例125个动脉瘤中，用MDS栓塞的(64例66个)与用GDC栓塞的(48例51个)病人、动脉瘤、栓塞结果和并发症等情况。结果　MDS和GDC两组病人的性别、年龄、治疗前有否蛛网膜下腔出血、Hunt-Hess氏分级、动脉瘤体长径(8.46±3.42mm与7.38±3.45mm)和颈宽(3.49±1.50mm与3.26±1.52mm)、栓塞所用弹簧圈的平均个数(4.65±3.04与4.24±2.65)和长度(460.2±398.5mm与422.9±387.1mm)、栓塞百分比(95.00%±6.32%与94.19%±7.63%，栓塞≥80%的病例)、以及死亡和永久并发症合计发生率(7.8%与4.2%)等均无显著性统计差异(t或χ2检验，P值均＞0.10)。结论　MDS和GDC都是颅内动脉瘤栓塞治疗的有效材料。MDS价格相对较低，操作需一定的经验和技巧；GDC选择规格多，操作相对简单、安全，适应证更宽。正确选择MDS或GDC(或联合应用)，可安全有效经济地治疗动脉瘤。
목적　비교궤계가탈식탄황권(mechanical detachable spiral,MDS)여전해가탈식탄황권(Guglielmi detachable coil，GDC)낭내전새로내동맥류。방법　대비분석1995년3월지1999년7월120례125개동맥류중，용MDS전새적(64례66개)여용GDC전새적(48례51개)병인、동맥류、전새결과화병발증등정황。결과　MDS화GDC량조병인적성별、년령、치료전유부주망막하강출혈、Hunt-Hess씨분급、동맥류체장경(8.46±3.42mm여7.38±3.45mm)화경관(3.49±1.50mm여3.26±1.52mm)、전새소용탄황권적평균개수(4.65±3.04여4.24±2.65)화장도(460.2±398.5mm여422.9±387.1mm)、전새백분비(95.00%±6.32%여94.19%±7.63%，전새≥80%적병례)、이급사망화영구병발증합계발생솔(7.8%여4.2%)등균무현저성통계차이(t혹χ2검험，P치균＞0.10)。결론　MDS화GDC도시로내동맥류전새치료적유효재료。MDS개격상대교저，조작수일정적경험화기교；GDC선택규격다，조작상대간단、안전，괄응증경관。정학선택MDS혹GDC(혹연합응용)，가안전유효경제지치료동맥류。
Objective　To evaluate the MDS(Mechanical Detachable Spiral)/GDC (Guglielmi Detachable Coil) embolization effects of intracranial saccular aneurysms. Methods　Among 120 cases of intracranial aneurysm (125) during March 1995 to July 1999, 65 cases (66 aneurysms) were embolized with MDS, 48 (51) with GDC and 8 with a combination of MDS and GDC. Clinical material including sex, age, SAH and Hunt & Hess Scale, diameter and neck width of aneurysm, the number and length of coils used per aneurysm, occlusive ratio and complications were compared between MDS and GDC groups. Results　MDS and GDC groups were comparable (P＞0.10) in terms of age, sex, diameter of aneurysm(8.46±3.42mm verse 7.38±3.45mm), neck width (3.49±1.50mm NS 3.26±1.52mm). Among those occluded ≥80%, MDS verse GDC: the average occlusive ratios, 95.00%±6.32∶94.19%±7.63%；permanent complications (including death), 7.8% NS 4.2%；Average coils and length per aneurysm, 4.65±3.04 NS 4.24±2.65 and 460.2±398.5mm NS 422.9±387.1mm. Conclusions　Although no significant differeace was found when compared MDS with GDC, GDC is more preferable regarding its good compliance, alternative types ready for use, tractability, especially for early ruptured and wide-neck aneurysms. Comparably, MDS is not promising as to its difficulty of control, possible propensity of complication, and potentiality of dissolution in spite of its good thrombogenesis and inexpensiveness.