颅内动脉瘤与动眼神经麻痹的相关性分析.docVIP

颅内动脉瘤与动眼神经麻痹的相关性分 析 郭平平 吴娜 程洁 万亮 王晓蓉 刘振国 上海交通大学医学院附属新华医院神经内科上海交 通大学医学院附属新华医院神经外科 摘要： 目的比较伴发动眼神经麻痹(OMNP)与非动眼神经麻痹(NOMNP)的颅内动脉 (IA)瘤患者在各临床因素之间的差异性，并为其诊断及治疗提供依据。方法收 集本院神经内科及神经外科2014年1月至2016年12月连续入组的224例经DSA 确诊的单侧单发IA患者的临床资料，记录以下因素:性别、年龄、首发症状、受 累眼肌表现、动脉瘤部位及最大直径、是否伴发蛛网膜下隙出血(SAH)、手术 方式及预后等。对1A的部位进行统计，并将其中的后交通动脉瘤按照其首发症 状分为动眼神经麻痹(OMNP)组及非动眼神经麻痹(NOMNP)组，分析两组之间 的差异性。结果(1)对动脉瘤部位分析统计可知，后交通动脉(74例，33.0%) 最常见；(2) N0MNP组患者发生SAII的概率(84.91%)要明显高于0MNP组 (19. 05%)。结论以动眼神经麻痹为首发症状的患者，需排除动脉瘤的存在。对 于继发于后交通动脉瘤的动眼神经麻痹患者，给予及时的干预措施，可预防动 脉瘤破裂并改善预后。 关键词： 颅内动脉瘤;动眼神经麻痹;后交通动脉;蛛网膜下腔岀血;相关性; 作者简介： 王晓蓉，Email:wangxiaorong@xinhuamed? com? cn 收稿日期：2017-05-22 基金：慢性病综合防治项目(SHD Analysis of correlation between intracranial aneurysms and oculomotor nerve paralysis GUO Ping-ping WU Na CHENG Jie WAN Liang WANG Xiao-rong LIU Zhen-guo Department of Neurology, the Xinhua Hospital, Shanghai Jiaotong University; Abstract： Objective To analyze and compare the differences of clinical factors between patients with oculomotor nerve palsy and without oculomotor nerve palsy, and to provide evidence for the diagnosis and treatment of intracranial aneurysms (IA) . Methods Collect the clinical data of two hundred and twenty four patients withunilateral single IA diagnosed by DSA in the Affiliated Xinhua Hospiteil of Shanghai Jiaotong Univcrsity School of Medicine Department of Neurology and Department of Neurosurgery from January 2014 to December 2016, and the following factors were recorded:Sex, age, onset symptoms, involvement of ocular muscle performance, aneurysm site and the largest diameter, whether associated with subarachnoid hemorrhage (SAII) , surgical methods and prognosis. The location of intracranial aneurysms was statistically analyzed and the patients with posterior communicating aneurysms were divided into two groups according to their first symptom:Oculomotor nerve palsy (OMXP) group and Non-oculomotor nerve palsy (NOMNP) group. Compare the differcnces bctwecn the two groups. RcsuIts (1) Analytic stati