[1]张晓冬,吴海涛,孙晓川,等.夹闭和栓塞治疗颅内动脉瘤对蛛网膜下腔出血脑血管痉挛的影响[J].陆军军医大学学报(原第三军医大学学报),2010,32(19):2071-2074.
　Zhang Xiaodong,Wu Haitao,Sun Xiaochuan,et al.Effect of clipping and embolization of intracranial aneurysm on cerebral vasospasm in patients with subarachnoid hemorrhage[J].J Amry Med Univ (J Third Mil Med Univ),2010,32(19):2071-2074.
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陆军军医大学学报（原第三军医大学学报）[ISSN:1000-5404/CN:51-1095/R]

卷:
32卷
期数:
2010年第19期
页码:
2071-2074
栏目:
论著
出版日期:
2010-10-15

文章信息/Info

Title:
Effect of clipping and embolization of intracranial aneurysm on cerebral vasospasm in patients with subarachnoid hemorrhage
作者:
张晓冬; 吴海涛; 孙晓川; 朱继; 唐文渊
重庆医科大学附属第一医院神经外科
Author(s):
Zhang Xiaodong;  Wu Haitao;  Sun Xiaochuan;  Zhu Ji;  Tang Wenyuan
Department of Neurosurgery, First Affiliated Hospital,  Chongqing Medical University, Chongqing, 400016, China
关键词:
颅内动脉瘤; 瘤颈夹闭术; 栓塞; 血管痉挛; 蛛网膜下腔出血
Keywords:
intracranial aneurysm;  cerebral vasospasm;  ;  therapeutic embolization;  surgery;  subarachnoid hemorrhage
分类号:
R651.1+2; R743.35
文献标志码:
A
摘要:
目的　研究夹闭和栓塞两种治疗方法对颅内动脉瘤性蛛网膜下腔出血所致脑血管痉挛的影响。　方法　  对123例颅内动脉瘤破裂导致蛛网膜下腔出血患者进行回顾性研究。分为2组，显微瘤颈夹闭组90例，血管内栓塞组33例。使用多元逻辑回归对治疗方式、性别、年龄、发病至入院时间、动脉瘤尺寸、部位、数量、Hunt分级、监护时间、住院时间进行统计学研究，明确影响脑血管痉挛及症状性脑血管痉挛的危险因子。　结果　  在动脉瘤显微手术夹闭组中，100%的患者发生了脑血管痉挛，75.6%的患者发生了症状性脑血管痉挛；在血管内栓塞组中，84.8%的患者发生了脑血管痉挛，45.5%发生了症状性脑血管痉挛。脑血管痉挛程度的独立预测因子是年龄较大，小动脉瘤，发病至入院时间短，Fisher 分级3、4级，Hunt和Hess分级Ⅲ、Ⅳ级；症状性脑血管痉挛的独立预测因子是动脉瘤位于后循环，Hunt和Hess分级Ⅱ、Ⅲ、Ⅳ级。　结论　和显微瘤颈夹闭术比较，血管内栓塞治疗术所致脑血管痉挛程度较轻，症状性脑血管痉挛的发生率也降低。
Abstract:
Objective   To study the effect of clipping and embolization of intracranial aneurysm on cerebral vasospasm due to subarachnoid hemorrhage.  Methods One hundred and twenty-three patients with subarachnoid hemorrhage due to rupture of intracranial aneurysm admitted is our department from March 2007 to December 2009 were divided into clipping group (n=90) and embolization group (n=33). Treatment modality, and sex, age, time from occurrence of disease to admission, ICU and hospital stay time of patients, as well as size, site, Hunt grade and number of aneurysms were calculated and analyzed. Effect of clipping and embolization of intracranial aneurysm on cerebral vasospasm and symptomatic cerebral vasospasm was observed and risk factors for cerebral vasospasm were analyzed.  Results   Cerebral vasospasm and symptomatic cerebral vasospasm occurred in 100% and 75.6% patients of clipping group, and in 84.8% and 45.5% patients of embolization group. Age, small intracranial aneurysm, Fisher grades 3 and 4, Hess grades Ⅲ and Ⅳ, short time from occurrence of disease to admission are independent predicting factors for cerebral vasospasm. Anterior circulation aneurysm, Hunt and Hess gradesⅡ-Ⅳ are independent predicting factors for symptomatic cerebral vasospasm.  Conclusion   Cerebral vasospasm and symptomatic cerebral vasospasm caused by intravascular embolization are milder than those caused by clipping.

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更新日期/Last Update: 2010-10-08