[1]宋志强,朱安林,陈锐锋,等.颅内动脉瘤急症介入术后神经系统并发症相关因素探讨[J].介入放射学杂志,2019,28(05):411-414.
 SONG Zhiqiang,ZHU Anlin,CHEN Ruifeng,et al.Discussion on the related factors of neurological complications after emergency percutaneous intervention for intracranial aneurysms[J].journal interventional radiology,2019,28(05):411-414.
点击复制

颅内动脉瘤急症介入术后神经系统并发症相关因素探讨()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
28
期数:
2019年05期
页码:
411-414
栏目:
神经介入
出版日期:
2019-05-25

文章信息/Info

Title:
Discussion on the related factors of neurological complications after emergency percutaneous intervention for intracranial aneurysms
作者:
宋志强 朱安林 陈锐锋 林 成 李 浩 徐恒周
Author(s):
SONG Zhiqiang ZHU Anlin CHEN Ruifeng LIN Cheng LI Hao XU Hengzhou.
Department of Neurosurgery, Civil Aviation General Hospital, Beijing 100123, China
关键词:
【关键词】 颅内动脉瘤 血管内介入术 神经系统并发症 脑梗死
文献标志码:
A
摘要:
【摘要】 目的 探讨颅内动脉瘤急症介入术后发生神经系统并发症的相关因素。方法 收集2010年1月至2017年12月采用急症介入术治疗的颅内动脉瘤破裂患者453例临床资料。根据是否发生神经系统并发症分为并发症组和无并发症组。观察分析患者并发症发生情况和发生率,并通过单因素统计分析及多因素logistic回归分析探讨并发症发生原因及独立危险因素。结果 453例患者中共有59例(13.0%)发生神经系统并发症,多为血栓栓塞,其次为术后早期再破裂出血和术中动脉瘤破裂。单因素分析结果显示,有高血压病史、脑梗死病史、Fisher分级Ⅲ~Ⅳ级、WFNS分级Ⅲ~Ⅴ级、Hunt- Hess分级Ⅳ~Ⅴ级以及宽颈动脉瘤、动脉瘤囊有小阜和瘤体形态不规则患者神经系统并发症发生率明显更高(P<0.05)。多因素logistic回归分析显示,有高血压病史、宽颈动脉瘤、动脉瘤囊有小阜、瘤体形态不规则以及Fisher分级Ⅲ~Ⅳ级、WFNS分级Ⅲ~Ⅴ级、Hunt- Hess分级Ⅳ~Ⅴ级为介入术后发生神经系统并发症的独立危险因素(P<0.05)。结论 临床治疗急症颅内动脉瘤中对有高血压病史、宽颈动脉瘤、动脉瘤囊有小阜、瘤体形态不规则以及Fisher分级Ⅲ~Ⅳ级、WFNS分级Ⅲ~Ⅴ级、Hunt- Hess分级Ⅳ~Ⅴ级患者应予以重视,给予针对性治疗,以减少神经系统并发症发生。

参考文献/References:

[1] 段国礼, 诸德源, 张晓曦, 等. 颅内破裂动脉瘤老年患者介入治疗神经系统并发症的危险因素分析[J]. 中国脑血管病杂志, 2017, 14: 4- 9.
[2] 谭华桥, 周育苗, 方 淳, 等. 血管内介入治疗周围型颅内动脉瘤17例[J]. 介入放射学杂志, 2016, 25: 279- 285.
[3] Liu H, Park D, Hwang SM, et al. Outpatient day- care neuroangiography and neurointervention of unruptured intracranial aneurysms[J]. Neurointervention, 2016, 11: 37- 41.
[4] 侯 青, 徐跃峤, 程玮涛, 等. 支架辅助弹簧圈栓塞颅内动脉瘤围手术期严重神经系统并发症的分析[J]. 中国脑血管病杂志, 2016, 13: 262- 265.
[5] Rozell JM, Mtui E, Pan YN, et al. Infectious and inflammatory diseases of the central nervous system. The spectrum of imaging findings and differential diagnosis[J]. Emerg Radiol, 2017, 24: 619- 633.
[6] 陈宗涛. 影响颅内动脉瘤介入治疗预后的相关因素分析[J]. 医学临床研究, 2017, 34: 2437- 2438.
[7] Ruggieri M, Milone P, Pavone P, et al. Nevus vascularis mixtus (cutaneous vascular twin nevi) associated with intracranial vascular malformation of the Dyke- Davidoff- Masson type in two patients[J]. Am J Med Genet A, 2012, 158A: 2870- 2880.
[8] 杨少春, 黄小玉, 邱传珍, 等. 颅内破裂微小动脉瘤介入栓塞治疗技术探讨[J]. 介入放射学杂志, 2016, 25: 11- 14.
[9] Cataltepe S, Arikan MC, Liang X, et al. Fatty acid binding protein 4 expression in cerebral vascular malformations: implications for vascular remodelling[J]. Neuropathol Appl Neurobiol, 2015, 41: 646- 656.
[10] 李星海, 赵 卫, 杨净松, 等. 脑动静脉畸形伴发动脉瘤的出血风险因素分析及介入治疗[J]. 中国介入影像与治疗学, 2018, 15: 204- 208.
[11] 卡合尔曼?卡德尔, 阿西木江?阿西尔, 特吾尔巴提?苏尔丹尼亚, 等. 小脑动脉远端动脉瘤的介入治疗[J]. 中国微侵袭神经外科杂志, 2016, 21: 533- 535.
[12] Shankar JJ, Lum C, Chakraborty S, et al. Cerebral vascular malformations: time- resolved CT angiography compared to DSA[J]. Neuroradiol J, 2015, 28: 310- 315.
[13] Josephson CB, Rosenow F, Salman RA. Intracranial vascular malformations and epilepsy[J]. Semin Neurol, 2015, 35: 223- 234.
[14] 方 娟, 石先琴. 脑肿瘤合并脑血管畸形的高危因素分析[J]. 现代肿瘤医学, 2016, 24: 1045- 1048.
[15] Qassim AM, Guan S, Saidi H, et al. Effectiveness of MRA on embolized intracranial aneurysms: a comparison of DSA, CE- MRA, and TOF- MRA[J]. J Intervent Med, 2018, 1: 32- 41.
[16] 霍晓川, 李佑祥, 江裕华, 等. Onyx胶栓塞结合伽玛刀治疗颅内动静脉畸形的疗效分析[J]. 中华神经外科杂志, 2015, 31: 1126- 1130.
[17] Choudhri O, Ivan ME, Lawton MT. Transvenous approach to intracranial arteriovenous malformations: challenging the axioms of arteriovenous malformation therapy?[J]. Neurosurgery, 2015, 77: 644- 651.
[18] Youssef M, Zerwes S, Jakob R, et al. Endovascular aneurysm sealing(EVAS) and chimney EVAS in the treatment of failed endovascular aneurysm repairs[J]. J Endovasc Ther, 2017, 24: 115- 120.
[19] 张彦冰, 管 生, 郭新宾, 等. 颅内动脉瘤介入治疗围术期缺血并发症病因分析与防治(附48例报告)[J]. 介入放射学杂志, 2017, 26: 291- 295.
[20] Ruhnke H, Kroencke TJ. Visceral artery aneurysms and pseudo- aneurysms: retrospective analysis of interventional endovascular therapy of 43 aneurysms[J]. Rofo, 2017, 189: 632- 639.

相似文献/References:

[1]邢 鸣,杨鹏飞,黄清海,等.支架治疗颈内动脉分叉部宽颈动脉瘤[J].介入放射学杂志,2012,(02):92.
 XING Ming,YANG Peng-fei,HUANG Qing-hai,et al.Stent implantation for the treatment of wide-necked aneurysms located at internal carotid artery bifurcation[J].journal interventional radiology,2012,(05):92.
[2]黄海东,顾建文,杨春敏,等.Enterprise支架辅助弹簧圈栓塞治疗前交通宽颈动脉瘤的临床研究[J].介入放射学杂志,2012,(07):536.
 HUANG Hai- dong,GU Jian- wen,YANG Chun-min,et al. Enterprise stent- assisted coil embolization for wide?蛳 necked anterior communicating artery aneurysms: a clinical study[J].journal interventional radiology,2012,(05):536.
[3]陆 靖,李永东,李明华,等. 时间飞越法磁共振血管造影对蛛网膜下腔出血诊断和治疗的临床价值[J].介入放射学杂志,2012,(09):711.
 LU Jing,LI Yong- dong,LI Ming- hua,et al. The clinical value of time- of-flight MRA in diagnosing and treating subarachnoid haemorrhage[J].journal interventional radiology,2012,(05):711.
[4]田红岸,赵 卫,易根发. 动脉灌注替罗非班在处理颅内动脉瘤栓塞术中急性血栓栓塞的研究[J].介入放射学杂志,2012,(09):718.
 TIAN Hong- an,ZHAO Wei,YI Geng-fa.. Application of intra- arterial infusion of tirofiban in dealing with acute thromboembolism occurred during embolization therapy for intracranial aneurysms: a preliminary study[J].journal interventional radiology,2012,(05):718.
[5]陈 状,李 林,王伟民,等. SolitaireAB支架结合弹簧圈治疗颅内宽颈动脉瘤的初步经验[J].介入放射学杂志,2013,(06):447.
 CHEN Zhuang,LI Lin,WANG Wei? min,et al. SolitaireAB stent- assisted coiling of intracranial wide- necked aneurysms: preliminary experience[J].journal interventional radiology,2013,(05):447.
[6]田红岸,赵 卫,易根发. 颅内动脉瘤内支架辅助治疗的并发症分析[J].介入放射学杂志,2012,(11):885.
 TIAN Hong- an,ZHAO Wei,YI Geng- fa.. Endovascular stent- assited management for the treatment of intracranial aneurysms: an analysis of complications[J].journal interventional radiology,2012,(05):885.
[7]温宏峰,赵春霞,李继来,等. 双微导管技术栓塞颅内宽颈不规则动脉瘤[J].介入放射学杂志,2012,(11):890.
 WEN Hong- feng,ZHAO Cun- xia,LI Ji- lai,et al. Double microcatheter technique for detachable coil treatment of wide?蛳 necked and irregular intracranial aneurysms[J].journal interventional radiology,2012,(05):890.
[8]崔艳峰,徐 浩,祖茂衡,等. Solitaire AB支架在辅助栓塞颅内宽颈动脉瘤中的临床应用[J].介入放射学杂志,2013,(08):617.
 CUl Yan? feng,XU Hao,ZU Mao? heng,et al. Clinical application of Solitaire AB stent in assisting coiling embolization for intracranial wide?蛳 necked aneurysms[J].journal interventional radiology,2013,(05):617.
[9]郄福忠,马光涛,王玖飞,等.大脑中动脉分叉部动脉瘤的血管内介入治疗[J].介入放射学杂志,2014,(08):655.
 QIE Fu zhong,MA Guang tao,WANG Jiu fei,et al.Endovascular interventional embolization for the treatment of aneurysms located at the bifurcation of middle cerebral artery[J].journal interventional radiology,2014,(05):655.
[10]程少容,曾晓华,王 鹰,等.320排动态容积CT血管造影对颅内动脉瘤手术前后评估的研究[J].介入放射学杂志,2013,(10):793.
 CHENG Shao? rong,ZENG Xiao? hua,WANG Ying,et al. Application of 320?蛳 detector dynamic volume CT angiography in evaluating preoperative and postoperative intracranial aneurysms[J].journal interventional radiology,2013,(05):793.

备注/Memo

备注/Memo:
(收稿日期:2018-07-25)
(本文编辑:边 佶)
更新日期/Last Update: 2019-05-11