摘要
目的探讨未破裂脑动静脉畸形(CAVM)伴癫痫患者血管内栓塞的疗效及临床预后。方法回顾性分析本院2014年1月-2018年12月收治未破裂CVAM伴癫痫患者共104例的临床资料,均行血管内栓塞治疗,比较治疗前后NIHSS评分、mRS评分、头疼严重程度分级、Spetzler-Martin分级、Engel分级及QOLIE-31量表评分。结果患者治疗后NIHSS评分和mRS评分显著低于治疗前(P<0.05)。患者治疗后头疼轻度比例显著高于治疗前(P<0.05);患者治疗后头疼中度和重度比例均显著低于治疗前(P<0.05);患者治疗后Spetzler-Martin分级和Engel分级I-II级比例显著高于治疗前(P<0.05);患者治疗后Spetzler-Martin分级和Engel分级III-IV级比例显著低于治疗前(P<0.05)。患者治疗后情感、精力、发作担忧、综合健康状态及社会功能评分均显著高于治疗前(P<0.05);治疗前后药物影响评分比较无显著性差异(P>0.05)。Spetzler-Martin分级低级别组患者平均QOLIE-31量表评分显著高于高级别组(P<0.05);完全及次全栓塞组平均QOLIE-31量表评分显著高于部分栓塞组(P<0.05);Engel分级预后良好组平均QOLIE-31量表评分显著高于预后不良组(P<0.05)。结论未破裂CVAM伴癫痫患者血管内栓塞可有效保护神经功能,控制病情进展,降低癫痫发作严重程度,并有助于改善生存质量;患者生活质量改善与AVM形态结构、栓塞程度及癫痫发作控制效果密切相关。
Objective To investigate the clinical efficacy and prognosis of intravascular embolization in the treatment of patients with unruptured CVAM and epilepsy.Methods Clinical data of 104 patients with unruptured CVAM and epilepsy were chosen from January 2014 to December 2018 in our hospital and endovascular embolization was performed in all patients. The NIHSS scores, mRS scores, severity grade of headache, Spetzler-Martin grade, Engel grade and QOLIE-31 scores of all patients were compared before and after treatment.Results The NIHSS scores and mRS scores after treatment of all patients were significantly less than those before treatment(P<0.05). The proportion of mild grade of headache after treatment of all patients were significantly higher than those before treatment(P<0.05). The proportion of middle and severe grade of headache after treatment of all patients were significantly lower than those before treatment(P<0.05). The proportion of I-II degree foe Spetzler-Martin grade and Engel grade after treatment of all patients were significantly higher than those before treatment(P<0.05). The proportion of III-IV degree foe Spetzler-Martin grade and Engel grade after treatment of all patients were significantly lower than those before treatment(P<0.05). The emotional, energetic, episodic anxiety, comprehensive health status and social function scores after treatment of all patients were significantly more than those before treatment(P<0.05). There was no significant difference in the drug impact score between before and after treatment(P>0.05).Conclusion Intravascular embolization in the treatment of patients with unruptured CVAM and epilepsy could efficiently protect the nervous function, control the disease progress, reduce the severity of epileptic seizures and be helpful to improve the quality of life.
作者
武跃辉
单峤
李培栋
高东海
王新军
Wu Yuehui;Dan Qiao;Li Peidong(The Second Neurosurgery Ward,Department of Neurosurgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou450052)
出处
《卒中与神经疾病》
2020年第2期185-188,共4页
Stroke and Nervous Diseases
关键词
脑动静脉畸形
癫痫
血管内栓塞
疗效
预后
CVAM
Epilepsy
Endovascular embolism
Clinical effect
Prognosis
