Onyx胶介入栓塞法与伽玛力治疗颅内动静脉畸形对照研究

Comparative study of Onyx glue embolization method and Gamma knife for arterovenous malformations

目的探讨Onyx胶介入栓塞法治疗颅内动静脉畸形(AVM)患者临床效果及术后近、中期预后。方法选取郑州大学附属南阳医院2014-04—2016-06收治的69例AVM患者,按照随机数字表法分组,对照组34例给予伽玛刀治疗,观察组35例予以Onyx胶介入栓塞法治疗,观察2组病灶治疗效果、病灶体积缩小情况、住院时间及改良Rankin评分,并统计2组并发症发生情况及生活质量(QOL)评分。结果观察组完全栓塞率为65.71%(23/35),高于对照组的26.47%(9/34),差异有统计学意义(P<0.05);观察组病灶体积缩小程度大于对照组,差异有统计学意义(P<0.05);术后3个月及1a观察组改良Rankin评分均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.71%(2/35),低于对照组的26.47%(9/34),差异有统计学意义(P<0.05);术后3个月观察组QOL评分高于对照组,差异有统计学意义(P<0.05)。结论 Onyx胶介入栓塞法可改善AVM患者神经功能,缩小病灶体积,提高生活质量,完全栓塞率高,并发症发生率低。

Objective To investigate the clinical effect of Onyx glue embolization in the treatment of arterovenous malfor- mations （AVM） and its postoperative follow-up study in near and medium term. Methods From April 2014 to June 2016, selected 69 patients with AVM in our hospital were randomly divided into control group （n= 34） and observation group （n = 35）, the con- trol group was treated with Gamma knife, and the observation group was treated with Onyx adhesion embolization. Lesion treatment, lesion size reduction, hospital stay, and improved Rankin score were observed and compared between the two groups. The in- cidence of complications and the quality of life （QOL） score were statistically analyzed. Results The total embolization rate was 65.71% （23/35） in the observation group,which was higher than that in the control group （26.47%, 9/34）, the difference was statistically significant （P^0. 05）. The size of the lesion in the observation group was larger than that in the control group, the difference was statistically significant （P〈0.05）. The corrected Rankin score of the observation group was lower than that of the control group at 3 months and 1 year after operation, the difference was statistically significant （P〈0. 05）. The incidence of com- plications in the observation group was 5.71 % （2 / 35 ）, which was lower than that in the control group （ 26.47 %, 9/34 ）, the differ- ence was statistically significant （P〈0.05）. The QOL score of the observation group was higher than that of the control group at 3 months after operation, the difference was statistically significant （P〈0.05）. Conclusion Onyx adiplectic embolization can im- prove the neurological function, reduce the lesion volume, improve the quality of life in AVM patients with higher embolization rate and the lower incidence of complication.