不同血管介入治疗方案对颅内动脉瘤的临床效果比较

Effect of Different Interventional Therapy on Intracranial Aneurysm and its Influence on Prognosis

【目的】分析不同血管介入治疗方案对颅内动脉瘤的效果及对患者预后的影响。【方法】回顾性分析2010年2月至2015年5月本院收治的240例颅内动脉瘤患者的临床资料，包括基本情况、临床表现、血管内栓塞治疗方法、并发症及随访结果等，总结各种血管介入栓塞方案治疗颅内动脉瘤的效果。【结果】①本组240例患者，术后即刻造影致密栓塞116例（48．33%），瘤颈残留72例（30.00%），部分栓塞52例（21．67%）；②球囊辅助弹簧圈栓塞、支架辅助弹簧圈栓塞所占比例较高，不同血管内栓塞方案栓塞程度比较，差异无统计学意义（P〉0.05）；③术中并发症发生率为4．58%（11/240），术后并发症发生率为8．33%（20/240）；④术后12个月，预后不良13例（5．41%）。术后6、12个月Rankin评分低于术后3个月，差异均有统计学意义（均P〈0.05）。【结论】对颅内动脉瘤患者采用不同血管介入栓塞方案治疗均可收到较好的疗效，血管栓塞治疗后患者预后评分均有明显改善，以支架内辅助弹簧圈栓塞疗效最佳。

[Objective]To analyze the effect of different interventional therapy on intracranial aneurysm and its influence on prognosis.[Methods]The clinical data of 240 patients with intracranial aneurysms from February 2010 to May 2015 were retrospectively analyzed, including basic information, clinical manifestations, endovascular embolization, complications and follow-up results. The effect of various vascular interventional embolization for the treatment of intracranial aneurysms was summarized.IResultslAmong the 240 patients, 116 cases showed radiography dense embolization immediately after operation, 72 cases with residual tumor neck （30.00%）and 52 cases with partial embolization（21.67%）; the proportion of balloon assisted coils embolization and stent assisted coil embolization was higher ; there was no significant difference in the degree of embolization in different vascular embolization schemes（ P〈0.05）; the incidence of intraoperative complications was 4.58 （ 11 / 240 ）, and that of postoperative complications was 8.33 （20/ 240） ; the prognosis was poor in 13 cases （5.41%） in 12 months after operation. 6- 12 months after operation, the Rankin score was lower than that of 3 months after the operation, and the difference was statistically significant（ P 〈0.05）.[Conelusion]Different vascular interventional embolization treatment for patients with intracranial aneurysms can get better curative effect. After vascular embolization , the prognosis score of the patient has been improved obviously , in which the curative effect of the stent assisted coil embolization is optimal.