CAJ | 학술논문

目的：观察颅内动脉瘤（AN）在不同时机下行介入栓塞术的疗效差异及预后影响因素。方法回顾性分析2010年2月-2013年2月行血管内介入栓塞术的60例 AN 患者的临床资料，根据接受介入栓塞治疗的不同时间分为早期组（26例）和延期组（34）例，比较2组患者治疗后的栓塞程度和并发症发生情况，并观察所有患者的短期预后及相关影响因素。结果早期组完全栓塞的例数显著高于延期组（P ＜0．05），大部分栓塞和部分栓塞则无显著差异（P ＞0．05）；早期组并发症总发生率为7．69％，与延期组的总发生率20．59％比较无显著差异（P ＞0．05）；出院时短期预后良好43例（71．67％），预后不良17例（28．33％）；患者的性别、年龄、动脉瘤直径对短期预后无影响（P ＞0．05）；高血压病史、是否多发性动脉瘤、Hunt-Hess 分级及介入栓塞时机对预后有显著影响（P ＜0．05或 P ＜0．01）。结论 AN 患者在发病3 d 内行介入栓塞术可以显著提高完全栓塞的比例，且不会增加并发症的发生，患者有高血压病史、多发动脉瘤及高 Hunt-Hess 分级等因素会显著影响 AN 的预后。
목적：관찰로내동맥류（AN）재불동시궤하행개입전새술적료효차이급예후영향인소。방법회고성분석2010년2월-2013년2월행혈관내개입전새술적60례 AN 환자적림상자료，근거접수개입전새치료적불동시간분위조기조（26례）화연기조（34）례，비교2조환자치료후적전새정도화병발증발생정황，병관찰소유환자적단기예후급상관영향인소。결과조기조완전전새적례수현저고우연기조（P ＜0．05），대부분전새화부분전새칙무현저차이（P ＞0．05）；조기조병발증총발생솔위7．69％，여연기조적총발생솔20．59％비교무현저차이（P ＞0．05）；출원시단기예후량호43례（71．67％），예후불량17례（28．33％）；환자적성별、년령、동맥류직경대단기예후무영향（P ＞0．05）；고혈압병사、시부다발성동맥류、Hunt-Hess 분급급개입전새시궤대예후유현저영향（P ＜0．05혹 P ＜0．01）。결론 AN 환자재발병3 d 내행개입전새술가이현저제고완전전새적비례，차불회증가병발증적발생，환자유고혈압병사、다발동맥류급고 Hunt-Hess 분급등인소회현저영향 AN 적예후。
Objective To observe the efficacy differences and influencing factors of inter-ventional embolisation at different times on patients with intracranial aneurysm (AN).Methods The clinical data of 60 AN patients underwent interventional embolisation in our hospital from Feb. 2010 to Feb.2013 were retrospectively analyzed and divided into early group (26 cases)and post-poned group (34 cases)according to the interventional embolisation at different times.Embolism severity and complications were compared between two groups and the short-term outcomes and rel-evant influencing factors were observed.Results The number of complete embolism was larger in early group than that in postpone group (P <0.05),but there were no significant differences in major and partial embolisms (P > 0 .0 5 ).The total rate of complications in early group was 7.69%,but had no significant difference with the 20.59% in postpone group (P >0.05).43 pa-tients had well short-term outcomes and 17 with bad ones when discharg (P >0.05).Genders, ages and AN diameter had no effect on the short-term outcomes,but the history of hypertension,multiple aneuryson ,Hunt - Hess degrees and the times for interventional embolisation had significant association with the outcomes (P <0.05,P <0.01).Conclusion The interventional embolisation conducted within 3 d after AN onset can evidently improve the rate of complete em-bolism without increasing the rate of complications.Hypertension,multiple aneuryson and Hunt-Hess degrees are the risk factors that influence the outcomes of AN patients.