自膨式支架辅助弹簧圈栓塞治疗颅内动脉瘤的疗效及安全性分析

摘要 目的：探讨自膨式支架辅助弹簧圈栓塞治疗颅内动脉瘤的疗效及安全性。方法：回顾性分析2014年1月-2019年1月我院采取自膨式支架辅助弹簧圈栓塞治疗颅内动脉瘤患者159例（A组）及采取单纯弹簧圈栓塞治疗颅内动脉瘤患者178例（B组），比较两种手术方法治疗颅内动脉瘤的手术时间、术后住院时间、随访时间、手术相关并发症发生率并通过格拉斯哥（GOS）预后评分、Raymond分级比较2种治疗方法的安全性及有效性。结果：两组手术时间、术后住院时间、随访时间比较差异无统计学意义（P＞0.05）。两组术后出血及缺血事件发生率差异有统计学意义（P＜0.05），脑积水、肺炎发生率、致死率及致残率差异无统计学意义（连续校正后P=1）。术后1月内及术后12个月随访GOS评分，A组评分高于B组，差异具有统计学意义（P＜0.05）；术后1月内及术后12个月随访Raymond分级，A组优于B组，差异具有统计学意义（P＜0.05）。结论：自膨式支架辅助弹簧圈栓塞治疗颅内动脉瘤栓塞效果明显且术后并发症少，对于颅内动脉瘤患者在弹簧圈栓塞基础上应用自膨式支架辅助可提高手术安全性及栓塞的疗效。

Efficacy and Safety of Self Expanding Stent Assisted Coil Embolization in the Treatment of Intracranial Aneurysms

ABSTRACT Objective: To explore the efficacy and safety of self expanding stent assisted coil embolization in the treatment of intracranial aneurysms. Methods: From January 2014 to January 2019,159 patients with intracranial aneurysms were treated with self expanding stent assisted coil embolization (group A) and 178 patients with intracranial aneurysms (group B) were treated with simple coil embolization.The operative time, postoperative hospital stay, follow-up time and complications of the two methods were compared, and the safety and efficacy of the two methods were compared by Glasgow(GOS) prognosis score and Raymond score. Results: There was no significant difference in operation time, postoperative hospitalization time and follow-up time between the two groups(P>0.05). There was significant difference in the incidence of postoperative bleeding and ischemic events between the two groups (P<0.05), but there was no significant difference in the incidence of hydrocephalus, pneumonia, mortality and disability between the two groups(P=1 after continuous correction). The GOS score of group A was higher than that of group B within 1 month and 12 months after operation, the difference was statistically significant(P<0.05); the Raymond grade of group A was better than that of group B within 1 month and 12 months after operation, the difference was statistically significant(P<0.05). Conclusion: Self expanding stent assisted coil embolization is effective for intracranial aneurysm embolization and has few postoperative complications. For patients with intracranial aneurysms, self expanding stent assisted coil embolization can improve the safety of operation and the efficacy of embolization.