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破裂前沟通动脉动脉瘤与小脑内血瘤并发:疏散血瘤还是不疏散血瘤?

Jiawei Cai^1,2,3, Chao He⁴, Jiaheng Xu^1,2,3

¹Department of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China.

Neuropsychiatric disease and treatment

|August 29, 2023

概括

在前沟通动脉 (AcomA) 动脉瘤破裂的患者中,疏散小额内血瘤 (ICH) 并没有改善结果,并且与更多的术后心脏病发作有关. 没有ICH疏散的动脉瘤治疗对这些患者来说似乎更安全.

科学领域:

神经外科神经外科
神经学神经学
血管外科血管外科

背景情况:

破裂前沟通动脉 (AcomA) 动脉瘤可以导致内血瘤 (ICH).
与AcomA动脉瘤并发的小型ICH (<25毫升) 的最佳管理仍在争论中.
对AcomA动脉瘤的手术包括动脉瘤剪切或内血管卷曲.

研究的目的:

为了确定小ICH (10-25毫升) 的疏散是否能改善AcomA动脉瘤破裂患者的预后.
为了比较接受ICH疏散的患者和没有接受ICH疏散的患者之间的结果.
评估两组手术后心脏病发作的发生率.

主要方法:

在2010年至2018年期间治疗的58名破裂的AcomA动脉瘤和小ICHs患者的回顾性分析.
患者被分为两组:接受ICH疏散的患者和没有接受ICH疏散的患者.
在发病后六个月使用修改的兰金度量表 (mRS) 评估预后.

主要成果:

ICH疏散与较高的不良结果率相关 (68.4%与33.3%,P = 0.001).
在ICH疏散组中,术后心脏病发作发生的频率更高 (57.9%对23.1%,P = 0.009).
平均ICH体积为15.27±4.07毫升.

结论:

破裂的AcomA动脉瘤和小血瘤 (<25毫升) 的患者的ICH疏散与较差的结果和心脏病发作的风险增加有关.
没有ICH疏散的动脉瘤治疗 (剪切或卷曲) 可能是一个更安全和有效的策略.
需要进一步的研究来证实这些发现,并指导临床决策.

关键词:

在 AcomA 动脉瘤.在ICH疏散.心脏病发作的心脏病发作内血瘤是一种内血瘤.预后预后预后

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