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中华介入放射学电子杂志 ›› 2020, Vol. 08 ›› Issue (02) : 151 -154. doi: 10.3877/cma.j.issn.2095-5782.2020.02.010

所属专题： 文献；

神经介入

血管内栓塞治疗后交通动脉动脉瘤性动眼神经麻痹临床效果及预后因素分析
赵飞龙1, 王斌1, 祖庆泉1, 赵林波1, 贾振宇1, 施海彬1, 刘圣1,†()   
  1. 1. 210029　江苏南京，南京医科大学第一附属医院介入放射科
  • 收稿日期:2020-02-07 出版日期:2020-05-25
  • 通信作者: 刘圣

Analysis of clinical effect and prognostic factors of oculomotor nerve palsy induced by posterior communicating artery aneurysms after endovascular embolization

Feilong Zhao1, Bin Wang1, Qingquan Zu1, Linbo Zhao1, Zhenyu Jia1, Haibin Shi1, Sheng Liu1,†()   

  1. 1. Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Nanjing 210029, China
  • Received:2020-02-07 Published:2020-05-25
  • Corresponding author: Sheng Liu
  • About author:
    Corresponding author: Liu Sheng, E-mail:
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赵飞龙, 王斌, 祖庆泉, 赵林波, 贾振宇, 施海彬, 刘圣. 血管内栓塞治疗后交通动脉动脉瘤性动眼神经麻痹临床效果及预后因素分析[J]. 中华介入放射学电子杂志, 2020, 08(02): 151-154.

Feilong Zhao, Bin Wang, Qingquan Zu, Linbo Zhao, Zhenyu Jia, Haibin Shi, Sheng Liu. Analysis of clinical effect and prognostic factors of oculomotor nerve palsy induced by posterior communicating artery aneurysms after endovascular embolization[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2020, 08(02): 151-154.

目的

探讨并分析经血管内栓塞治疗后交通动脉（posterior communicating artery，PComA）动脉瘤性动眼神经麻痹（oculomotor nerve palsy，ONP）的临床效果和预后影响因素。

方法

回顾性分析2010年4月至2018年10月期间，在我科接受血管内栓塞治疗的57例PComA动脉瘤性ONP患者的临床资料及随访资料。按其术后恢复程度分为治愈（完全恢复）组和非治愈（部分恢复+未恢复）组，分析比较两组患者的相关资料。

结果

57例患者中，42例完全恢复，13例部分恢复，2例未恢复，治愈组与非治愈组在术前麻痹程度（73.8% vs 26.7%，P=0.002）以及是否伴有蛛网膜下腔出血（54.8% vs 20%，P=0.033）差别具有统计学意义。

结论

血管内栓塞治疗可促进PComA动脉瘤性ONP患者症状恢复，术前麻痹程度较轻以及伴有蛛网膜下腔出血的ONP患者经血管内栓塞治疗后症状更容易恢复。

关键词: 后交通动脉动脉瘤, 动眼神经麻痹, 血管内栓塞治疗, 预后因素
Objective

To explore and analyze the clinical effects and prognostic factors of oculomotor nerve palsy (ONP) induced by posterior communicating artery (PComA) aneurysms after endovascular embolization.

Methods

The clinical data and follow-up data of 57 patients with PComA aneurysmal ONP who underwent endovascular embolization in our department from April 2010 to October 2018 were retrospectively analyzed. According to the degree of postoperative recovery, they were divided into a cured (complete recovery) group and a non-cured (partial recovery + no recovery) group. The relevant data of the two groups of patients were analyzed and compared.

Results

Among 57 patients, 42 patients recovered completely, 13 patients recovered partially, and 2 patients did not recover. The degree of paralysis before surgery (73.8% vs 26.7%, P=0.002) and whether there was a subarachnoid hemorrhage (54.8% vs 20%, P=0.033) was statistically significant differences.

Conclusions

Endovascular embolization therapy can promote the recovery of symptoms in patients with PComA aneurysmal ONP. The symptoms of ONP patients with mild preoperative paralysis and subarachnoid hemorrhage are more easily recovered after endovascular embolization.

Key words: Posterior communicating artery aneurysm, Oculomotor nerve palsy, Endovascular embolization, Prognostic factor
表1 两组患者一般资料比较
? 治愈组n=42 非治愈组n=15 t/χ2值 P值
年龄 61±11 61±8 -0.157 0.876
性别 ? ? 0.529 0.599
? 男 3 2 ? ?
? 女 39 13 ? ?
高血压史 ? ? 0.000 1.000
? 有 20 7 ? ?
? 无 22 8 ? ?
蛛网膜下腔出血 ? ? 5.384 0.003
? 有 20 3 ? ?
? 无 22 12 ? ?
术前麻痹时间 ? ? 2.619 0.106
? <2周 34 9 ? ?
? ≥2周 8 6 ? ?
术前麻痹程度 ? ? 10.365 0.002
? 完全性 11 12 ? ?
? 部分性 31 3 ? ?
动脉瘤大小 ? ? 3.040 0.081
? ≤7 mm 8 7 ? ?
? >7 mm 34 8 ? ?
是否为宽颈动脉瘤 ? ? 0.000 1.000
? 是 30 11 ? ?
? 否 12 4 ? ?
[1]
高飞，饶克成，廖磊．血管内栓塞治疗后交通动脉瘤引起的动眼神经麻痹临床观察[J]．中国实用神经疾病杂志，2016, 19(13): 98-99.
[2]
Dimopoulos VG, Fountas KN, Feltes CH, et al. Literature review regarding the methodology of assessing third nerve paresis associated with non-ruptured posterior communicating artery aneurysms[J]. Neurosurg Rev, 2005, 28(4): 256-260.
[3]
Yang MQ, Wang S, Zhao YL, et al. Postoperative recovery from posterior communicating aneurysm complicated by oculomotor palsy[J]. Chin Med J (Engl), 2008, 121(12): 1065-1067.
[4]
Gao G, Gu DQ, Zhang Y , et al. Comparison of the efficacy of surgical clipping and embolization for oculomotor nerve palsy due to a posterior communicating artery aneurysm[J]. European Review for Medical & Pharmacological Sciences, 2017, 21(2): 292-296.
[5]
Chen PR, Amin-Hanjani S, Albuquerque FC，et a1．Outcome of oculomotor nerve palsy from posterior communicating artery aneurysms：comparison of clipping and coiling[J]. Neurosurgy，2006, 58(6): 1040-1046．
[6]
Sheehan MJ, Dunne R, Thornton J, et al. Endovascular repair of posterior communicating artery aneurysms, associated with oculomotor nerve palsy: A review of nerve recovery[J]. Interventional Neuroradiology, 2015, 21(3): 312-316.
[7]
KO HJ, KIM YJ. Oculomotor nerve palsy caused by posterior communicating artery aneurysm: evaluation of symptoms after endovascular treatment[J]. Interventional Neuroradiology, 2011, 17(4): 415-419.
[8]
顾大群，张扬，晁迎九，等．后交通动脉动脉瘤致动眼神经麻痹的预后分析[J]．中国临床神经外科杂志，2014, 19(10): 587-589.
[9]
李光标，邱修辉，叶远良，等．伴动眼神经麻痹的后交通动脉动脉瘤的血管内治疗[J]．中国临床神经外科杂志，2018, 23(2): 107-108.
[10]
Hanse MCJ, Gerrits MCF, Van Rooij WJ, et al. Recovery of Posterior Communicating Artery Aneurysm-Induced Oculomotor Palsy after Coiling[J]. American Journal of Neuroradiology, 2008, 29(5): 988-990.
[11]
Gu DQ, Luo B, Zhang X, et al. Recovery of posterior communicating artery aneurysm-induced oculomotor nerve paresis after endovascular treatment[J]. Clinical Neurology and Neurosurgery, 2012, 114(9): 1238-1242.
[12]
Zhang SH, Pei W, Cai XS, et al. Endovascular Management and Recovery from Oculomotor Nerve Palsy Associated with Aneurysms of the Posterior Communicating Artery[J]. World Neurosurgery, 2010, 74(2-3): 316-319.
[13]
宋贵军，尹琳，王君．血管内介入治疗后交通动脉瘤性动眼神经麻痹的疗效及其影响因素研究[J]．临床神经病学杂志，2012, 25(2): 30-32.
[14]
Kassis SZ, Jouanneau E, Tahon FB, et al. Recovery of third nerve palsy after endovascular treatment of posterior communicating artery aneurysms[J]. World Neurosurgery, 2010, 73(1): 11-16.
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