血管内栓塞治疗后交通动脉动脉瘤性动眼神经麻痹临床效果及预后因素分析

Analysis of clinical effect and prognostic factors of oculomotor nerve palsy induced by posterior communicating artery aneurysms after endovascular embolization

目的探讨并分析经血管内栓塞治疗后交通动脉(posterior communicating artery,PComA)动脉瘤性动眼神经麻痹(oculomotor nerve palsy,ONP)的临床效果和预后影响因素。方法回顾性分析2010年4月至2018年10月期间,在我科接受血管内栓塞治疗的57例PComA动脉瘤性ONP患者的临床资料及随访资料。按其术后恢复程度分为治愈(完全恢复)组和非治愈(部分恢复+未恢复)组,分析比较两组患者的相关资料。结果 57例患者中,42例完全恢复,13例部分恢复,2例未恢复,治愈组与非治愈组在术前麻痹程度(73.8%vs 26.7%,P=0.002)以及是否伴有蛛网膜下腔出血(54.8%vs 20%,P=0.033)差别具有统计学意义。结论血管内栓塞治疗可促进PComA动脉瘤性ONP患者症状恢复,术前麻痹程度较轻以及伴有蛛网膜下腔出血的ONP患者经血管内栓塞治疗后症状更容易恢复。

Objective To explore and analyze the clinical effects and prognostic factors of oculomotor nerve palsy(ONP)induced by posterior communicating artery(PComA)aneurysms after endovascular embolization.Methods The clinical data and follow-up data of 57 patients with PComA aneurysmal ONP who underwent endovascular embolization in our department from April 2010 to October 2018 were retrospectively analyzed.According to the degree of postoperative recovery,they were divided into a cured(complete recovery)group and a non-cured(partial recovery+no recovery)group.The relevant data of the two groups of patients were analyzed and compared.Results Among 57 patients,42 patients recovered completely,13 patients recovered partially,and 2 patients did not recover.The degree of paralysis before surgery(73.8%vs 26.7%,P=0.002)and whether there was a subarachnoid hemorrhage(54.8%vs 20%,P=0.033)was statistically significant differences.Conclusions Endovascular embolization therapy can promote the recovery of symptoms in patients with PComA aneurysmal ONP.The symptoms of ONP patients with mild preoperative paralysis and subarachnoid hemorrhage are more easily recovered after endovascular embolization.