论文部分内容阅读
目的探讨血管内栓塞术治疗后交通动脉动脉瘤(PcomAA)所致的动眼神经麻痹患者的恢复情况及其影响因素。方法从2006年6月2009年11月对连续收住院的19例伴有动眼神经麻痹的PcomAA患者采用动脉瘤栓塞术。其中男1例,女18例;平均年龄53岁。动脉瘤直径平均为7.9 mm。发病到治疗的时间平均为16.7 d。利用确切概率法分析下列因素与动眼神经麻痹恢复程度之间的关系。具体包括:最初动眼神经麻痹的程度、动脉瘤的大小、是否伴有蛛网膜下腔出血(SAH)、发病至开始治疗的时间。结果①19例患者治疗时均为完全栓塞。②术后随访时间平均为3.1个月。12例患者动眼神经麻痹完全恢复正常,7例患者的症状部分恢复。其中1例患者因1年后动脉瘤复发行二次栓塞术,2年后再次造影随访证实动脉瘤栓塞致密。该患者在二次治疗后2个月余动眼神经麻痹症状恢复,且未出现症状反复的情况。③动眼神经麻痹程度、发病到开始治疗时间及是否伴有SAH,对恢复情况均有影响(P<0.05);动脉瘤的大小对恢复情况无影响(P>0.05)。结论动脉瘤栓塞术是PcomAA所致的动眼神经麻痹的有效治疗方式。在患者群中,尽早治疗的、伴有SAH或动眼神经麻痹程度较轻者,其预后良好。
Objective To investigate the recovery of oculomotor nerve paralysis caused by transcatheter arterial aneurysm (PcomAA) and its influencing factors after endovascular embolization. Methods From June 2006 to November 2009, 19 consecutive patients with PcomAA with oculomotor palsy admitted to hospital were treated with aneurysm embolization. There were 1 males and 18 females, with an average age of 53 years. The average diameter of aneurysms was 7.9 mm. The average time from onset to treatment was 16.7 days. Use the exact probability method to analyze the relationship between the following factors and the recovery of oculomotor nerve palsy. Including: the initial degree of oculomotor nerve paralysis, aneurysm size, whether accompanied by subarachnoid hemorrhage (SAH), the onset of treatment to the time. Results ① All the 19 patients were completely embolized during the treatment. ② The average follow-up time was 3.1 months. Twelve patients recovered completely with oculomotor nerve paralysis and some of the seven patients recovered. One patient was diagnosed aneurysm embolism densely after angiography follow-up two years later because of aneurysm recurrence after one year. The patient recovered from oculomotor palsy symptoms 2 months after the second treatment without recurrence of symptoms. (3) The degree of oculomotor nerve paralysis, onset and treatment time, and the presence or absence of SAH had an effect on the recovery (P <0.05). The size of the aneurysm had no effect on the recovery (P> 0.05). Conclusion Aneurysm embolization is an effective treatment for oculomotor nerve paralysis caused by PcomAA. In the patient group, the earliest treatment, accompanied by SAH or ocular motor nerve paralysis less, the prognosis is good.