【摘要】 目的比较血管内介入栓塞与开颅夹闭治疗脉络膜前动脉动脉瘤的临床效果,分析脉络膜前动脉动脉瘤预后相关影响因素。方法对南昌大学第二附属医院2014年1月至2019年1月收治的98例脉络膜前动脉动脉瘤患者的临床资料进行回顾性分析,其中采用血管内介入栓塞治疗72例(A组),采用开颅夹闭治疗26例(B组)。采用改良RanKin量表评价2组的预后,采用Raymond分级评估2组动脉瘤闭塞情况,观察2组术后缺血并发症发生情况;采用单因素分析脉络膜前动脉动脉瘤预后相关影响因素。结果 A组预后良好66例(91.7%)、动脉瘤完全闭塞65例(90.3%)、术后发生缺血并发症10例(13.9%),B组分别为23例(88.5%)、25例(96.2%)、5例(19.2%),2组预后良好率、动脉瘤完全闭塞率、术后缺血并发症发生率比较差异均无统计学意义(均P>0.05)。单因素分析结果显示,动脉瘤大小是脉络膜前动脉动脉瘤预后的影响因素(χ~2=5.624,P=0.018)。结论介入栓塞和开颅夹闭治疗脉络膜前动脉动脉瘤均能取得满意疗效,动脉瘤大小是其预后影响因素。术前充分评估及个性化治疗对于提高预后良好率有重要意义。更多还原

【Abstract】 Objective To compare the clinical effects of endovascular embolization and surgical clipping on anterior choroidal artery aneurysm,and to analyze the prognostic factors.MethodsClinical data of 98 patients with anterior choroidal artery aneurysm admitted to the Second Affiliated Hospital of Nanchang University from January 2014 to January 2019 were analyzed retrospectively.These patients were treated with either endovascular embolization(group A,72 patients) or surgical clipping(group B,26 patients).The prognosis was evaluated using the modified RanKin Scale,and aneurysm occlusion was assessed by Raymond grading.Postoperative ischemic complications were observed,and prognostic factors were analyzed by univariate analysis.ResultsIn group A,66 patients(91.7%) had favorable prognosis,65 patients(90.3%) had complete aneurysm occlusion,and 10 patients(13.9%) had postoperative ischemic complications.In group B,23 patients(88.5%) had favorable prognosis,25 patients(96.2%) had complete aneurysm occlusion,and 5 patients(19.2%) had postoperative ischemic complications.The differences were not significant between the two groups(P>0.05).Univariate analysis showed that aneurysm size is a factor influencing the prognosis of anterior choroidal artery aneurysm(χ~2=5.624,P=0.018).ConclusionBoth endovascular embolization and surgical clipping can achieve satisfactory therapeutic effects on anterior choroidal artery aneurysm.Aneurysm size is a factor affecting the prognosis.Preoperative evaluation and individualized treatment have important significance for improving the prognosis.更多还原