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| 脑膜中动脉栓塞治疗慢性硬脑膜下血肿:单中心经验 |
| 左乔△,唐海双△,殷洪伟,仇成傑,赵瑞,李强,方亦斌,黄清海,许奕,洪波,周晓平,王来兴,杨鹏飞,刘建民* |
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(海军军医大学(第二军医大学)长海医院脑血管病中心, 上海 200433
△共同第一作者
*通信作者) |
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| 摘要: |
| 目的 分析脑膜中动脉（MMA）栓塞治疗慢性硬脑膜下血肿的有效性和安全性。方法 回顾性连续纳入2018年3月至2020年5月在海军军医大学（第二军医大学）长海医院脑血管病中心接受MMA栓塞治疗的慢性硬脑膜下血肿患者19例，分析MMA栓塞术后3个月血肿复发和进展情况，以及技术成功率和技术相关并发症的发生率。结果 19例患者中男17例、女2例，年龄为51~85岁，平均年龄为（67.4±7.9）岁。共21例侧慢性硬脑膜下血肿，其中6例侧行单纯MMA栓塞，15例侧行MMA栓塞联合钻孔引流（MMA栓塞后钻孔引流7例侧，钻孔引流后MMA栓塞8例侧）。21例侧血肿MMA栓塞术均获得成功，其中17例侧使用Onyx胶栓塞，4例侧使用Glubran胶栓塞。19例患者均无技术相关并发症。19例患者均接受临床和影像学随访，术后临床症状均明显缓解，术后3个月均未见血肿复发和进展。结论 MMA栓塞是慢性硬脑膜下血肿一种新的治疗方法，安全性高，血肿复发率低，但该结论仍需大样本随机对照试验验证。 |
| 关键词: 慢性硬脑膜下血肿 治疗性栓塞 脑膜中动脉 治疗结果 |
| DOI：10.16781/j.0258-879x.2021.02.0157 |
| 投稿时间：2020-10-12修订日期：2020-12-18 |
| 基金项目: |
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| Middle meningeal artery embolization for chronic subdural hematoma: a single-center experience |
| ZUO Qiao△,TANG Hai-shuang△,YIN Hong-wei,QIU Cheng-jie,ZHAO Rui,LI Qiang,FANG Yi-bin,HUANG Qing-hai,XU Yi,HONG Bo,ZHOU Xiao-ping,WANG Lai-xing,YANG Peng-fei,LIU Jian-min* |
(Stroke Center, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To analyze the efficacy and safety of middle meningeal artery (MMA) embolization in the treatment of chronic subdural hematoma. Methods Nineteen consecutive patients with chronic subdural hematoma, who received MMA embolization in the Stroke Center of Changhai Hospital of Naval Medical University (Second Military Medical University) from Mar. 2018 to May 2020, were included retrospectively. The recurrence and progress of hematoma, technical success rate and incidence of procedure-related complications were analyzed 3 months after MMA embolization. Results Of the 19 patients, 17 were males and 2 females, aged 51-85 years, with an average age of (67.4±7.9) years. There were 21 hematomas in the 19 patients. Of them, 6 hematomas underwent simple MMA embolization and 15 underwent MMA embolization combined with burr-hole drainage (7 burr-hole drainage after MMA embolization and 8 before embolization). Procedures for all the 21 hematomas were successfully performed, and 17 of them were treated with Onyx glue and 4 with Glubran glue. No patients had technique-related complications. All the 19 patients received clinical and imaging follow-up, and the clinical symptoms were all improved, and none of them had recurrence or progress of hematoma 3 months after embolization. Conclusion MMA embolization is a new treatment for chronic subdural hematoma with high safety and low recurrence rate. However, this result needs to be further verified by large-scale randomized controlled trials. |
| Key words: chronic subdural hematoma therapeutic embolization middle meningeal artery treatment outcome |
