弹簧圈栓塞治疗颅内动脉瘤107例临床分析.pdfVIP

162 J Clin Neumsurg December 2007，Vot．4，No．4 · 论著 · 弹簧圈栓塞治疗颅内动脉瘤1 07例临床分析 魏建军，邱胜利，张扬，晁迎九，傅先明，牛朝诗 【摘要】 目的 探讨颅内动脉瘤的临床特点，以及影响动脉瘤致密栓塞的相关临床因素。方法 对 107例破裂动脉瘤采取弹簧圈栓塞治疗，DSA随访78例。分析破裂动脉瘤临床特点，对影响动脉瘤致密栓塞 临床因素进行单因素x 检验及Logistic回归分析。结果 完全栓塞89例(83．2％)，90％栓塞12例(11． 2％)，90％栓塞6例(5．6％)。随访78例动脉瘤，致密填塞的6l例弹簧圈均稳定，部分填塞的l7例：7例 稳定，4例缩小；6例扩大，再次栓塞。无再出血。死亡1例(0．93％)，重残2例(1．9％)，轻度神经功能缺失 症状3例(2．8％)。动脉瘤部位与性别关系经过线性相关性分析，P=0．103，0．05。影响动脉瘤致密栓塞 因素的Logistic回归分析显示：动脉瘤部位、形态、Fisher分级、血管痉挛情况对决定能否致密栓塞的OR值分 别为0．392(P=0．005)、0．310(P=0．030)、0．501(P=0．039)、0．566(P=0．095)。结论 弹簧圈栓塞颅内动 脉瘤的关键是致密栓塞；动脉瘤部位、形态、Fisher分级、脑血管痉挛评分与动脉瘤致密栓塞与否相关，评分越 低，致密栓塞的概率越大。 【关键词】 颅内动脉瘤；弹簧圈；栓塞；Logistic回归 【中图分类号】R734．4 【文献标识码】A 【文章编号】1672—7770(2007)04—0162-03 Clinical analysis of 107 cases intracraniai aneurysms treated by endovascular coil occlusion WEI Jianjun，QIU Sheng—li，ZHANG Yang，et a1．Department of NeurosurgeO，Anhui Provincial Hospital Affiliated to Anhui Medical University，Hefei 230001，China Abstract：Objective To explore the clinical feature and factors of contribution to complete obliteration of intraeranial aneurysm．Methods 1 07 cases of ruptured anemTsm were embolismed by coils and 78 oases were follow—up by DSA．The clinical feature of ruptured aneurysm and the factors of complete obliteration were analysed by Logistic regression．Results Complete obliteration were in 89 cases(83．2％)，90％obliterations were in 12 cases (11．2％)and90％ obliterations were in 6 cases(5．6％)．Among 78 cases of follow—up，there were 61 cases achiving density obliteration and the coils appearing steady．On the contrary，there were 17 cases achiving partial obliteration，in which the coils were steady in eases，shrunk in 4，enlarged in 6，and the latter were treated by embolism again．All cases without newly hemorrhage．1 case dead(