CAJ | 학술논문

目的：探讨累及胚胎型后交通动脉动脉瘤的介入治疗策略及临床效果。方法回顾性分析徐州医学院附属医院介入科2009年1月到2014年4月收治的13例累及胚胎型后交通动脉动脉瘤患者的资料，所有患者均采用介入栓塞治疗动脉瘤，通过数字减影血管造影、复查CT以及临床随访观察患者后交通动脉动脉瘤治疗效果，采用出院时改良RANKIN量表（mRS）评分评价患者预后。结果球囊辅助栓塞2例，支架辅助栓塞5例，直接栓塞6例。动脉瘤完全栓塞10例，部分栓塞3例。闭塞后交通动脉近端5例。所有患者后交通动脉保留通畅。术中动脉瘤破裂1例，予以继续填塞而出血停止，术后即刻复查CT示少量蛛网膜下腔出血。术后脑积水行脑脊液分流术1例。出院时改良mRS评分0级11例，1级1例，6级1例。随访时间6~24个月，平均（12±3）个月，无再次出血。结论对于累及胚胎型后交通动脉动脉瘤，针对累及胚胎型后交通动脉的程度采用不同的治疗策略，可取得较好临床效果，远期疗效需进一步观察。
목적：탐토루급배태형후교통동맥동맥류적개입치료책략급림상효과。방법회고성분석서주의학원부속의원개입과2009년1월도2014년4월수치적13례루급배태형후교통동맥동맥류환자적자료，소유환자균채용개입전새치료동맥류，통과수자감영혈관조영、복사CT이급림상수방관찰환자후교통동맥동맥류치료효과，채용출원시개량RANKIN량표（mRS）평분평개환자예후。결과구낭보조전새2례，지가보조전새5례，직접전새6례。동맥류완전전새10례，부분전새3례。폐새후교통동맥근단5례。소유환자후교통동맥보류통창。술중동맥류파렬1례，여이계속전새이출혈정지，술후즉각복사CT시소량주망막하강출혈。술후뇌적수행뇌척액분류술1례。출원시개량mRS평분0급11례，1급1례，6급1례。수방시간6~24개월，평균（12±3）개월，무재차출혈。결론대우루급배태형후교통동맥동맥류，침대루급배태형후교통동맥적정도채용불동적치료책략，가취득교호림상효과，원기료효수진일보관찰。
Objective To investigate the treatment strategies and clinical efficacy of interventional therapy for fetal posterior communicating artery aneurysms (PCOAA). Methods A retrospective analysis was performed of clinical data from 13 patients with fetal PCOAA treated at the Department of Interventional Radiology,Affiliated Hospital,Xuzhou Medical College between January 2009 and April 2014. All patients were treated with coil embolization of the aneurysms. DSA angiography,CT and clinical follow?up were conducted to observe the therapeutic efficacy of fetal PCOAA. Modified RANKIN Scale (mRS) scores at hospital discharge were used to evaluate the prognosis of patients. Results Of these patients,two were treated with balloon?assisted,five with stent?assisted and six with direct coil embolization of aneurysms. The coil embolization of aneurysm was complete in 10 patients and partial in 3. In 5 patients,the embolization was performed at the proximal part of posterior communicating artery. The posterior communicating artery retained patency after treatment. In one patient who experienced rupture of aneurysm during the procedure, the hemostasis was achieved by packing and the CT scan immediately after operation showed minimal subarachnoid hemorrhage. One patient required cerebrospinal fluid shunt for postoperative hydrocephalus. At discharge,there were 11 cases with mRS score grade 0,1 with grade 1,and 1 with grade 6. The during the follow?up of 6 to 24 months (mean 12 ± 3 months),there was no recurrence of bleeding in the patients. Conclusion For fetal PCOAA,different treatment strategies based on the extent of PCOAA can achieve favorable clinical outcomes,although the long?term effects require further observation.