血管内介入栓塞治疗基底动脉顶端动脉瘤效果及预后分析

Study on the effectiveness and prognosis of endovascular treatment of the basilar tip aneurysms

目的 探讨血管内介入栓塞治疗基底动脉顶端动脉瘤(BTA)的临床效果及预后情况。方法 选取北部战区总医院自2019年2月至2022年5月收治的76例采用血管内介入栓塞治疗的BTA患者为研究对象。根据不同的治疗方法将患者分为A组(n=26)与B组(n=50)。A组患者采用弹簧圈单纯栓塞治疗,B组患者采用支架辅助栓塞治疗。记录比较两组患者即刻栓塞效果、并发症发生情况、出院前后改良Rankin量表(mRS)评分。采用多因素Logistic回归分析评估患者出院后6个月预后的影响因素。结果 B组患者即刻动脉瘤近全闭塞率为96.00%(48/50),高于A组的84.62%(22/26),差异有统计学意义(P<0.05)。A组、B组患者并发症发生率分别为7.69%(2/26)、8.00%(4/50),差异无统计学意义(P>0.05)。B组出院后6个月的mRS评分优于A组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,手术方式为患者出院后6个月预后的影响因素(P<0.05)。结论 支架辅助栓塞治疗BTA患者的术后即刻栓塞效果优于弹簧圈单纯栓塞,且手术方式为患者远期预后的影响因素。

Objective To investigate the clinical effect and prognosis of endovascular embolization in the treatment of basilar tip aneurysms(BTA).Methods A total of 76 BTA patients treated with intravascular interventional embolization from February 2019 to May 2022 in General Hospital of Northern Theater Command were selected as the study objects.Patients were divided into group A(n=26)and group B(n=50)according to different treatment methods.Group A was treated with simple embolization of spring coil,group B was treated with stent assisted embolization.The results of immediate embolization,the occurrence of complications and the score of modified rankin scale(mRS)before and after discharge were recorded and compared between the two groups.Multivariate Logistic regression analysis was used to evaluate the factors affecting the prognosis of patients at six months after discharge.Results The rate of near total aneurysm occlusion in group B was 96.00%(48/50),higher than 84.62%(22/26)in group A,and the difference was statistically significant(P<0.05).The incidence of complications in group A and group B was 7.69%(2/26)and 8.00%(4/50),respectively,with no statistical significance(P>0.05).The mRS of group B at six months after discharge were better than those of group A,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the mode of operation was an influential factor for the prognosis of patients six months after discharge(P<0.05).Conclusion Stent assisted embolization is better than simple embolization of spring coil in BTA patients,and the operative method is an influential factor for long-term prognosis.