颈内动脉-后交通动脉瘤伴动眼神经麻痹大弹簧圈技术栓塞治疗的效果及安全性

Effect and safety of large coil technique in patients with internal carotid artery-posterior communicating artery aneurysm and oculomotor nerve palsy

目的分析颈内动脉-后交通动脉瘤伴动眼神经麻痹患者采用大弹簧圈技术栓塞治疗的效果及安全性。方法纳入2018-06—2021-06张家口市第一医院收治的98例颈内动脉-后交通动脉瘤伴动眼神经麻痹患者,对照组47例采用传统方式栓塞治疗,研究组51例采用大弹簧圈技术栓塞治疗。比较2组术后Raymond-Roy分级、动脉瘤填塞密度、动脉瘤复发、术后动眼神经恢复情况、动脉瘤术后GOS评分、术后并发症。结果研究组Raymond-Roy分级优于对照组(P<0.05)。研究组弹簧圈填塞密度高于对照组(P<0.05),动脉瘤复发率低于对照组(P<0.05)。研究组动眼神经恢复情况、发生死亡、植物生存、重残、轻残的情况与对照组相比无统计学差异(P>0.05),研究组恢复良好占比高于对照组(P<0.05)。2组术后并发症发生率无统计学差异(P>0.05)。研究组弹簧圈用量及弹簧圈费用均低于对照组(P<0.05)。结论大弹簧圈技术用于颈内动脉-后交通动脉瘤伴动眼神经麻痹患者的效果显著,能有效提高栓塞程度及密度,降低动脉瘤复发率,改善患者预后,安全性高,且能降低医疗费用。

Objective To analyze the effect and safety of large coil technique in patients with internal ca⁃rotid artery-posterior communicating artery aneurysm with oculomotor nerve palsy.Methods A total of 98 patients with internal carotid artery-posterior communicating artery aneurysm with oculomotor nerve palsy who were admit⁃ted to our hospital from June 2018 to June 2021 were selected.According to different treatment methods,they were divided into control group(47 cases)and study group(51 cases),which were treated with traditional emboli⁃zation and large coil technique respectively.The postoperative Raymond-Roy grade,aneurysm packing density,an⁃eurysm recurrence,postoperative oculomotor nerve recovery,postoperative GOS score,and postoperative complica⁃tions were compared between the two groups.Results The Raymond-Roy classification of the study group was better than that of the control group(P<0.05).The density of coil packing in the study group was higher than that in the control group(P<0.05),and the recurrence rate of aneurysm in the study group was lower than that in the control group(P<0.05).There was no difference in the recovery of oculomotor nerve,occurrence of death,plant survival,severe disability and minor disability between the study group and the control group(P>0.05).The pro⁃portion of good recovery in the study group was higher than that in the control group(P<0.05).There was no difference in the incidence of postoperative complications between the two groups(P>0.05).The amount of coils and the cost of coils in the study group were lower than those in the control group(P<0.05).Conclusion The large coil technique is effective in the treatment of patients with internal carotid artery-posterior communicating artery aneurysm with oculomotor nerve palsy,which can effectively improve the degree and density of embolism,reduce the recurrence rate of aneurysm,improve the prognosis of patients,high safety,and can reduce medical costs.