摘要
目的:分析三维数字减影血管造影(DSA)彩色融合技术在颅内动脉瘤患者介入术中导航定位应用的价值,探究预后的影响因素。方法:选择2021年11月至2025年1月在安徽省第二人民医院行颅内动脉瘤介入术的221例患者,依据术中导航方式的不同将其分为对照组(107例)和研究组(114例),为控制混杂偏倚,选取性别、年龄、婚姻状况、文化程度、高血压病史、糖尿病史、吸烟史及饮酒史共8项基线资料作为协变量,采用倾向性评分匹配进行1∶1最邻近匹配后两组各纳入52例患者,其基线特征均衡可比。对照组术中采用二维路径图导航,研究组术中采用三维DSA彩色融合技术辅助导航。比较两组手术总时长、微导管导引耗时和X射线透视时长,并对对比剂使用量、辐射剂量,空气比释动能(AK)和剂量-面积乘积(DAP)、手术并发症,以及预后不良的危险因素进行对比分析。结果:研究组手术总时长(92.34±10.26)min、微导管导引耗时(5.76±1.82)min、X射线透视时长(38.74±4.26)s,均较对照组的(101.54±9.25)min、(8.23±2.31)min和(51.27±5.49)s更短,两组比较差异有统计学意义(t=4.803、6.057、13.003,P<0.05);研究组对比剂使用量少于对照组,辐射剂量DAP和AK较对照组更少,两组比较差异有统计学意义(t=7.442、10.123、23.910,P<0.05);研究组术中导引难度更低,差异有统计学意义(Z=8.131,P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。二元logistic回归分析提示,手术时机、亨特-赫斯(Hunt-Hess)分级以及费舍尔(Fisher)分级是预后不良的危险因素(OR=5.397、5.765、6.786,P<0.05)。结论:颅内动脉瘤患者介入术中导航定位使用三维DSA彩色融合技术有较高的辅助应用价值。
Objective:To analyze application value of navigation and positioning of color fusion technique of three-dimensional(3D)digital subtraction angiography(DSA)in interventional surgery for patients with intracranial aneurysms,and to explore influencing factors of prognosis.Methods:From November 2021 to January 2025,a total of 221 patients who underwent intervention surgery for intracranial aneurysm at Anhui No.2 Provincial People's Hospital were selected,and they were divided into control group(n=107)and study group(n=114)according to different navigation methods during surgery.In order to control confounding bias,8 baseline data(gender,age,marital status,education level,hypertension,medical history,diabetes history,smoke history and drink alcohol history)were selected as covariate.After propensity score matching was adopted to conduct nearest marching as ratio of 1 to 1,each group enrolled 52 patients,and the characteristics of baseline should be balanced and comparable.The control group adopted twodimension(2D)path map to conduct navigation,while the study group adopted 3D DSA color fusion technique to assist navigation.The total duration of surgery,the time-consuming of microcatheter guidance,and the duration of X-ray fluoroscopy were compared between the two groups,and the used dosage of contrast agent,radiation dose,air kerma(AK),dose-area product(DAP),surgical complications and the risk factors of poor prognosis were compared and analyzed.Results:The total duration of surgery,the timeconsuming of microcatheter guidance,and the duration of X-ray fluoroscopy of the study group were respectively(92.34±10.26)min,(5.76±1.82)min and(38.74±4.26)s,all of which were shorter than those[(101.54±9.25)min,(8.23±2.31)min and(51.27±5.49)s]of the control group,and the differences were statistically significant(t=4.803,6.057,13.003,P<0.05).The used dosage of contrast agent of the study group was significantly less than that of the control group,and the DAP and AK of radiation dose were also significantly less than those of the control group(t=7.442,10.123,23.910,P<0.05).The difficulty of intraoperative guidance of the study group was lower than that of the control group,and the difference was statistical significance(Z=8.131,P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The binary logistic regression analysis showed that the timing of surgery,Hunt-Hess grade and Fisher grade were the risk factors that caused poor prognosis(OR=5.397,5.765,6.786,P<0.05),respectively.Conclusion:Using 3D DSA color fusion technique has higher auxiliary application value in navigation and positioning of interventional surgery for patients with intracranial aneurysms.
作者
肖彦
杜训松
孔令凤
朱晓婉
Xiao Yan;Du Xunsong;Kong Lingfeng;Zhu Xiaowan(Department of Radiology,Anhui No.2 Provincial People's Hospital,Hefei 230012,China)
出处
《中国医学装备》
2026年第2期63-68,共6页
China Medical Equipment
关键词
三维数字减影血管造影(DSA)
彩色融合技术
颅内动脉瘤
介入手术导航
Three-dimension digital subtraction angiography(DSA)
Color fusion technique
Intracranial aneurysm
Navigation of interventional surgery
