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Published on: July 21, 2013
中间脑膜动脉栓塞用于非急性亚皮血瘤
Jianmin Liu1, Wei Ni1, Qiao Zuo1
1From the Neurovascular Center (J. Liu, Q.Z., P.Z., L.C., Yongxin Zhang, F.S., Y. Wu, G.D., N.L., X.X., Zifu Li, Y. Zhou, L.Z., D.D., Yongwei Zhang, R.Z., Y.X., Q.L., P.Y.), Trauma Center (J. Liu, Q.Z.), and Department of Radiology (B.T.), Naval Medical University Changhai Hospital, the Key Laboratory of Molecular Neurobiology of the Ministry of Education, Naval Medical University (J. Liu, P.Y.), the Oriental PanVascular Devices Innovations College, University of Shanghai for Science and Technology (J. Liu, H.Z., P.Y.), the Departments of Neurosurgery (W.N., H.Y., J.Y., Z.D., J.H., Q.Y., G.W., C.G., X.W., H.J., J.S., Y.G., Y.M.) and Neurology (X.C., Z.W.), and the National Center for Neurological Disorders (Y.G., Y.M.), Fudan University Huashan Hospital, the Department of Neurosurgery, Fudan University Huashan Hospital North (Y. Lei, Yanjiang Li, L.X.), Neurosurgical Institute Fudan University and Shanghai Clinical Medical Center of Neurosurgery (Y.G., Y.M.), the Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (X.H.), the Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University (J. Wan), the Department of Neurosurgery, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Yi Li), and the Department of Neurosurgery, Shanghai Tenth People's Hospital (L.G.), Shanghai, the Department of Neurosurgery, First People's Hospital of Changzhou, Changzhou (Y.P.), the Department of Neurosurgery, First Affiliated Hospital of Ningbo University, Ningbo (Z. Lin), the Department of Neurosurgery, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Wuhu (Zhenbao Li), the Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng (J. Wang), the Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou (Y. Zhen), the Department of Neurosurgery, First Affiliated Hospital of Anhui Medical University, Hefei (J. Luo), the Department of Neurosurgery, First Affiliated Hospital of Fujian Medical University, Fuzhou (Y. Lin), the Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong (J.C.), the Department of Neurosurgery, Jiangsu Provincial Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing (H.L.), the Department of Neurosurgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou (M.Z.), the Department of Neurosurgery, Shantou Central Hospital, Shantou (M.L.), the Department of Neurosurgery, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou (J.Z.), the Department of Neurosurgery, Capital Medical University Beijing Chaoyang Hospital, Beijing (Y. Wang), the Department of Neurosurgery, Henan Provincial People's Hospital, Zhengzhou (T.L.), the Department of Neurosurgery, Second Affiliated Hospital of Nanchang University, Nanchang (G.M.), the Department of Neurosurgery, Zhongnan Hospital Wuhan University, Wuhan (W.Z.), the Department of Neurosurgery, the First Hospital of Hebei Medical University, Shijiazhuang (C.L.), and the Department of Neurosurgery, Zhongshan Hospital Xiamen University, Xiamen (E.C.) - all in China; the Departments of Diagnostic Imaging (J.M.O.), Radiology (M.G.), and Clinical Neurosciences (M.G.), University of Calgary, Calgary, AB, Canada; and the Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam (C.B.L.M.M.).
中脑膜动脉栓塞并没有显著降低腹膜下血瘤的复发,但在随机试验中降低了严重的不良事件. 这一发现为治疗慢性腹腔内血瘤提供了宝贵的见解.
科学领域:
- 神经外科和干预性放射学
- 血管干预 血管干预
- 神经外科手术 神经外科手术
背景情况:
- 中间脑膜动脉栓塞对于亚急性或慢性腹腔内血瘤的疗效尚不清楚.
- 腹膜下血腫的治療往往需要手術,但非急性病例存在管理不確定性.
研究的目的:
- 评估中脑膜动脉栓塞对非急性亚皮血瘤症状复发和进展的影响.
- 评估中脑膜动脉栓塞的安全概况,与该患者群体的通常护理相比.
主要方法:
- 一个多中心的,开放的,随机的试验,涉及722名患有症状的非急性亚皮血瘤的患者.
- 患者被随机分配到孔排水或保守治疗,然后进一步随机分配到中脑膜动脉栓塞或通常的护理.
- 主要结局是症状在90天内复发或进展;严重的不良事件被监测.
主要成果:
- 症状复发或进展发生在6.7%的栓塞组与9.9%的常规护理组 (P=0.10) 相比.
- 中脑膜动脉栓塞与严重不良事件发生率显著降低相关 (6.7%对11.6%,P=0.02).
- 在78.3%的患者中进行了孔排水,通常与栓塞结合.
结论:
- 中脑膜动脉栓塞的症状复发或进展率与非急性腹腔内血瘤的通常护理相比相似.
- 该程序与严重不良事件的发生率降低有关,这表明潜在的安全益处.
- 这些发现有助于理解栓塞在非急性亚皮血瘤管理中的作用,特别是当与排水相结合时.
相关概念视频
Hemorrhagic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology

