颅内动脉瘤血管内治疗临床研究

Clinical study on the Treatment of Intracranial Aneurysm Endovascular

目的分析颅内动脉瘤血管内治疗有效性、安全性、适应性。方法以神经外科收治并采用血管内介入技术治疗动脉瘤患者为研究对象,调取病历资料进行分析。结果共纳入患者344例,年龄19~89岁,部分有高血压、糖尿病等合并症;Hunt-Hess分级：0级55例,Ⅳ-Ⅴ级28例;动脉瘤大小2~29 cm;致密栓塞170例、部分栓塞72例;动脉瘤破裂11例,术中血栓形成20例,器械所致不良事件12例;短期死亡率4.94%,0~2分76.45%;随访时间1个月~3年,随访时间≥5个月者288例,其中稳定212例,随访时间≥12个月者241例,预后不佳15例,死亡6例;预后不佳与死亡患者Hunt-Hess等级、瘤体大小与预后较好患者差异有统计学意义（P〈0.05）。结论 血管内治疗适用于各年龄段、绝大多数颅内动脉瘤患者治疗,短期预后、长远预后均较好,死亡患者多为病情较重、出现破裂者。

Objective to analyze the intracranial aneurysm endovascular treatment effectiveness,safety,adaptability. Methods to Department of neurosurgery by endovascular treatment of intracranial aneurysms in patients with technology as the research object, obtaining medical records,analysis. Results of 344 patients enrolled,aged 19 to 89 years old,some have high blood pressure,dia-betes complications; Hunt-Hess grading：grade 0 in 55 cases,28 cases of grade IV-V;aneurysm size 2~29 cm;72 cases of partial embolization in 170 cases, dense embolization;11 cases of rupture of aneurysm,20 cases of formation thrombosis during operation, 12 cases of equipment caused by adverse events;the short-term mortality rate was 4.94%,0-2point：76.45%;the follow-up time ranged from 1 months to 3 years,288 cases were followed up for more than 5 months,which is stable in 212 cases,241 cases were followed up for more than 12 months,the prognosis is poor in 15 cases,6 cases of death;statistically significance of poor prognosis and death of patients in Hunt-Hess grade,tumor size and better prognosis in patients with difference（P〈0.05）. Conclusion endovas-cular treatment is suitable for all ages,the vast majority of patients with intracranial aneurysm treatment,the short-term prognosis and long-term prognosis was good,death rupture than for patients with severe condition, there are.