前交通动脉瘤介入术中胼胝体下动脉保护与前交通动脉综合征相关性研究

Correlation between the protection of subcallosal artery and the anterior communicating artery syndrome in interventional embolization of anterior communicating aneurysm

目的总结前交通动脉瘤血管内介入治疗的临床效果,探讨前交通动脉瘤介入术中保护胼胝体下动脉(SCA)与术后前交通动脉综合征发生的相关性。方法回顾性分析38例经介入治疗的前交通动脉瘤患者临床资料,根据术前脑血管造影SCA显影与否,分为显影组(n=20)和不显影组(n=18)。统计分析手术前后、随访时短期定向力-记忆力-注意力测试(SOMCT)评分及术后并发症发生情况。结果两组间术前和术后3个月SOMCT评分差异均无统计学意义(P>0.05),术后即刻、术后3 d、15 d、6个月SOMCT评分差异有统计学意义(P<0.05)。重复测量设计资料方差分析显示术前SCA显影组SOMCT评分均高于术前不显影组(F=9.96,P=0.003)。SCA显影组、不显影组术后发生高热、水电解质紊乱分别为18例、8例,18例,4例,差异均有统计学意义(P<0.05)。结论术前SCA显影与术后SOMCT评分升高密切相关,患者易发生高热、水电解质紊乱等并发症。术中保护SCA有助于降低并发症发生。

Objective To summarize the clinical effect of interventional embolization in treating anterior communicating aneurysms,and to explore the correlation between the protection of the subcallosal artery(SCA)and the occurrence of anterior communicating artery syndrome in interventional embolization of anterior communicating aneurysm.Methods The clinical data of 38 patients with anterior communicating aneurysm who underwent interventional embolization therapy were retrospectively analyzed.According to visualization or non-visualization of SCA on preoperative cerebral angiography,the patients were divided into visualization group(n=20)and non-visualization group(n=18).The short-term orientation-memoryconcentration test(SOMCT)scores were calculated before and after the treatment as well as at the followup examination,the postoperative complications were recorded,and the results were statistically analyzed.Results No statistically significant differences in preoperative and 3-month postoperative SOMCT scores existed between the two groups(P>0.05),while statistically significant differences in immediate,3-day,15-day and 6-month postoperative SOMCT scores existed between the two groups(P<0.05).Variance analysis showed that the preoperative SOMCT score in visualization group was higher than that in non-visualization group(F=9.96,P=0.003).Postoperative high fever and water-electrolyte disorder occurred in 18 patients and 18 patients respectively in visualization group,which were 8 patients and 4 patients respectively in non-visualization group,the differences between the two groups were statistically significant(P<0.05).Conclusion The preoperative visualization of SCA is closely related to the postoperative increased SOMCT score,such patients are easily to develop high fever and water-electrolyte disorder.The protection of SCA during interventional embolization procedure can help reduce the incidence of complications.