双微导管技术在血管内介入栓塞治疗老年颅内宽颈动脉瘤患者的有效性和安全性观察

Analysis of safety and efficacy of dual microcatheterization in the treatment of senile wide necked intracranial aneurysms by endovascular embolization

目的观察双微导管技术在血管内介入栓塞治疗老年颅内宽颈动脉瘤患者的临床效果及安全性。方法回顾性分析2014年1月—2016年9月四川大学华西医院神经外科收治的90例老年颅内宽颈动脉瘤患者的临床资料,按照治疗方式分为对照组(n=45)和观察组(n=45)。对照组采用手术夹闭治疗,观察组采用血管介入栓塞治疗且运用双微导管技术,比较2组临床疗效和安全性。结果观察组住院时间短于对照组(t=19.284,P=0.016),ADL评分高于对照组(t=22.105,P=0.043)、NIHSS评分低于对照组(t=16.926,P=0.038),恢复良好率高于对照组(x^2=6.947,P=0.032),致残率、植物生存率及病死率低于对照组(x^2=7.015、5.306、6.391,P=0.025、0.019、0.026),并发症总发生率低于对照组(x^2=7.031,P=0.033)。结论与手术夹闭治疗相比,老年颅内宽颈动脉瘤在血管内介入栓塞治疗时采用双微导管技术安全性较高,值得推广应用。

Objective To observe the clinical efficacy and safety of dual micro catheter technique in the treatment of elderly patients with intracranial wide neck aneurysms by endovascular embolization.Methods Retrospective analysis 90 cases elderly patients with intracranial wide neck aneurysms who treated in the Department of Neurosurgery of West China Hospital from January 2014 to September 2016,they were divided into control group（n = 45） and observation group（n =45） according to the method of treatment.The control group was treated with surgical clipping,and the observation group was treated with endovascular eniliolizalion.The clinical efficacy,safety and efficacy of the 2 groups were compared.Results After treatment,the observation group admission time was shorter than the control group（t =19.284;P =0.016）,ADL score higher than the control group（t =22.105,P =0.043）,NIHSS score lower than the control group（t=16.926,P =0.038）,the good recovery rale was higher than the control group（χ^2=6.947,P =0.032）.disability rate,plant survival rate and the mortality rate were lower than the control group（χ^2= 7.015,χ^2=5,306,χ^2 =6.391,P =0.025,P =0.019,P = 0.026）,the complication rate was lower than the control group（χ^2 =7.031,P=0.033）.Conclusion Compared with the surgical clipping treatment,the elderly patients with intracranial wide necked aneunsms in the endovascular eniliolizalion treatment with dual micro catheter technique is safe,worthy of popularization and application.