铂金弹簧圈与 HydroCoil 治疗未破裂颅内动脉瘤的疗效比较

目的 评价铂金弹簧圈与 HydroCoil 治疗未破裂颅内动脉瘤的疗效。方法 选择2011年4月～2015年4月在本院就诊的未破裂脑动脉瘤患者78例,随机分为水凝胶弹簧圈(HES)组40例和铂金弹簧圈(BPC)组38例,分别采用HES和BPC进行血管栓塞术,评价2组术后动脉瘤栓塞程度、栓塞密度弹簧圈使用数量和12个月后动脉瘤复发情况,并记录相关并发症。结果 HES组和BPC组完全栓塞率分别为84.21%(32/38)和75.00%(30/40),栓塞密度为0.329±0.143和0.668±0.227,组间比较均无明显差异(P>0.05); HES组达到完全栓塞所需要的弹簧圈少于BPC组(P<0.05); 2组并发症发生率分别为13.16%(5/38)和5.00%(2/40),组间比较无明显差异(χ²=1.588,P=0.208); 随访12个月后2组分别有35例和37例患者完成随访,复发率为14.29%(5/35)和18.92%(7/37),组间比较无明显差异(P>0.05); logistic回归分析表明只有血管瘤直径是复发的独立相关因素(P<0.05)。结论 HES治疗未破裂脑动脉瘤的完全栓塞率和远期复发率不能优于BPC组,而且价格高于BPC,不推荐HES作为首选方法。

The efficacy of platinum coil and hydrocoil on unruptured intracraninal

ObjectiveTo evaluate the efficacy of bare platinum coil and HydroCoil on unruptured intracranial aneurysms.Methods From April 2011 to April 2015, 78 patients with unruptured intracranial aneurysms at our hospital were randomly divided into hydrocephalus coil(HES)group(n=40)and bare platinum coil(BPC)group(n=38). The degree of embolization, the number of used coils and the recurrence rate of aneurysm after 12 months were evaluated. The complications were recorded at the same time.Results The complete embolization rates were 84.21%(32/38)and 75.00%(30/40)in the HES and BPC groups respectively. The embolization densities were 0.329±0.143 and 0.668±0.227 respectively.There was no significant difference between the two groups(P>0.05). The incidence of complications in the two groups was 13.16%(5/38)and 5.00%(2/40)and the difference was significant(χ²=1.588, P=0.208). After 12 months, there were 35 patients and 37 patients to be completed follow-up study, the recurrence rates were 14.29%(5/40), 18.92%(7/37)(P>0.05). Logistic regression analysis showed that only aneurysm diameter was an independent factor of relapse(P<0.05).Conclusion The complete embolization rate and long-term recurrence rate of HES in unruptured cerebral aneurysm could not be superior to BPC group and the price is higher in HES group than that in BPC group. So HES was not recommended as the preferred method.