摘要
目的比较支架植入术治疗特发性颅内高压(idiopathic intracranial hypertension,IIH)伴不同类型静脉窦狭窄(venous sinus stenosis,VSS)的效果。方法回顾性分析2019年1月至2023年9月在郑州大学第一附属医院接受支架植入术的48例IIH伴VSS患者的临床资料。根据VSS类型将患者分为内源性狭窄组(n=20)和外源性狭窄组(n=28)。对比分析两组患者症状改善、视乳头水肿Frisén分级、腰椎穿刺口压力(lumbar puncture opening pressure,LPOP)、静脉窦跨狭窄压力梯度(ΔP)以及手术相关并发症。结果内源性狭窄组患者年龄大于外源性狭窄组(41.6岁比35.3岁,P=0.049),外源性狭窄组患者狭窄节段长度长于内源性狭窄组(22.5 mm比19.0mm,P=0.007),两组间其余临床资料比较差异无统计学意义(均P>0.05)。两组患者支架植入术后ΔP中位数、LPOP平均值和视乳头水肿Frisén分级中位数均显著下降,且与术前相比差异有统计学意义(均P<0.001),但外源性狭窄组术后3 d中位Frisén分级更低(P=0.037)。随访1年,两组患者临床症状均有不同程度改善。除了出院时外源性狭窄组无视乳头水肿症状比例较高(57.1%比22.2%,P=0.049)外,两组间其他症状改善比较差异无统计学意义(均P>0.05)。两组间并发症发生率比较差异无统计学意义(P=0.563)。结论静脉窦支架植入术治疗IIH伴不同类型VSS患者均有效。
Objective To compare the efficacy of stenting in the treatment of idiopathic intracranial hypertension(IIH)complicated by different types of venous sinus stenosis(VSS).Methods The clinical data of 48 patients with IIH complicated by VSS,who received stenting therapy at the First Affiliated Hospital of Zhengzhou University of China from January 2019 to September 2023,were retrospectively analyzed.According to the type of VSS,the patients were divided into intrinsic stenosis group(n=20)and the extrinsic stenosis group(n=28).The improvement of symptoms,Frisén grade of papilledema,lumbar puncture opening pressure(LPOP),trans-stenosis pressure gradient(ΔP)of VSS,and surgeryrelated complications were compared between the two groups.Results The mean age of the patients in the intrinsic stenosis group was greater than that of the patients in the extrinsic stenosis group(41.60 years vs.35.25 years,P=0.049).The length of the narrowed segment in the extrinsic stenosis group was 22.5 mm,which was significantly longer than 19.0mm in the intrinsic stenosis group(P=0.007).The postoperative Frisen grade of papilledema in the extrinsic stenosis group was obviously lower than that in the intrinsic stenosis group(P=0.037).No statistically significant differences in the other clinical data existed between the two groups(all P>0.05).After stenting,all of the median ΔP,mean LPOP,and median Frisen grade of papilledema were decreased significantly when compared with their preoperative values(all P<0.001),and the postoperative 3-day median Frisen grade of papilledema in the extrinsic stenosis group was much lower(P=0.037).The patients were followed up for one year,the clinical symptoms of the patients in both groups were improved to varying degrees.At the time of discharge,the proportion of patients having no symptoms of papilledema in the extrinsic stenosis group was 57.1%,which was higher than 22.2%in the intrinsic stenosis group(P=0.049),and no statistically significant differences in the improvements of other symptoms existed between the two groups(all P>0.05).There was no significant difference in the incidence of complications between the two groups(P=0.563).Conclusion Venous sinus stenting can effectively treat patients with IIH complicated by different types of VSS.
作者
徐振
包雯颍
许莺歌
王晨
张松
朱明
吴垠垠
闫磊
水少锋
XU Zhen;BAO Wenying;XU Yingge;WANG Chen;ZHANG Song;ZHU Ming;WU Yinyin;YAN Lei;SHUI Shaofeng(Department of Interventional Radiology,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China;Department of Neurology,Suixian Country Hospital of Traditional Chinese Medicine,Suixian,Henan Province 476900,China)
出处
《介入放射学杂志》
北大核心
2025年第7期697-703,共7页
Journal of Interventional Radiology
关键词
特发性颅内高压
静脉窦狭窄
支架植入术
疗效
idiopathic intracranial hypertension
venous sinus stenosis
stenting
curative efficacy
作者简介
通信作者:水少锋,E-mail:shuishaofeng@126.com。
