2006年韩国未破裂颅内动脉瘤的治疗：来自韩国脑血管外科学会的全国多中心调查
Treatment of unruptured intracranial aneurysms in South Korea in 2006 : a nationwide multicenter survey from the korean society of cerebrovascular surgery.
作者信息
Kim Jeong Eun, Lim Dong-Jun, Hong Chang-Ki, Joo Sung-Pil, Yoon Seok-Mann, Kim Bum-Tae
机构信息
Department of Neurosurgery, College of Medicine, Seoul National University, Seoul, Korea.
出版信息
J Korean Neurosurg Soc. 2010 Feb;47(2):112-8. doi: 10.3340/jkns.2010.47.2.112. Epub 2010 Feb 28.
OBJECTIVE
There have been no clinical studies regarding the epidemiology and treatment outcome for unruptured intracranial aneurysm (UIA) in South Korea yet. Thus, The Korean Society of Cerebrovascular Surgery (KSCVS) decided to evaluate the clinical and epidemiological characteristics, and outcome of the treatment of UIA in 2006, using the nationwide multicenter survey in South Korea.
METHODS
A total of 1,696 cases were enrolled retrospectively over one year at 48 hospitals. The following data were obtained from all patients : age, sex, presence of symptoms, location and size of the aneurysm, treatment modality, presence of risk factors for stroke, and the postoperative 30-day morbidity and mortality.
RESULTS
The demographic data showed female predominance and peak age of seventh and sixth decades. Supraclinoid internal carotid artery was the most common site of aneurysms with a mean size of 5.6 mm. Eight-hundred-forty-six patients (49.9%) were treated with clipping, 824 (48.6%) with coiling, and 26 with combined method. The choice of the treatment modalities was related to hospital (p = 0.000), age (p = 0.000), presence of symptom (p = 0.003), and location of aneurysm (p = 0.000). The overall 30-day morbidity and mortality were 7.4% and 0.3%, respectively. The 30-day mortality was 0.4% for clipping and 0.2% for coiling, and morbidity was 8.4% for clipping and 6.3% for coiling. Age (p = 0.010), presence of symptoms (p = 0.034), size (p = 0.000) of aneurysm, and diabetes mellitus (p = 0.000) were significant prognostic factors, while treatment modality was not.
CONCLUSION
This first nation-wide multicenter survey on UIAs demonstrates the epidemiological and clinical characteristics, outcome and the prognostic factors of the treatment of UIAs in South Korea. The 30-day postoperative outcome for UIAs seems to be reasonable morbidity and mortality in South Korea.
目的
韩国尚未有关于未破裂颅内动脉瘤（UIA）的流行病学及治疗结果的临床研究。因此，韩国脑血管外科学会（KSCVS）于2006年决定通过韩国全国多中心调查来评估UIA的临床和流行病学特征以及治疗结果。
方法
48家医院在一年多的时间里共回顾性纳入了1696例病例。从所有患者处获取了以下数据：年龄、性别、症状表现、动脉瘤的位置和大小、治疗方式、中风危险因素的存在情况以及术后30天的发病率和死亡率。
结果
人口统计学数据显示女性占主导，发病高峰年龄在六七十岁。鞍上颈内动脉是最常见的动脉瘤部位，平均大小为5.6毫米。846例患者（49.9%）接受了夹闭治疗，824例（48.6%）接受了栓塞治疗，26例接受了联合治疗。治疗方式的选择与医院（p = 0.000）、年龄（p = 0.000）、症状表现（p = 0.003）以及动脉瘤位置（p = 0.000）有关。总体30天发病率和死亡率分别为7.4%和0.3%。夹闭治疗的30天死亡率为0.4%，栓塞治疗为0.2%；夹闭治疗的发病率为8.4%，栓塞治疗为6.3%。年龄（p = 0.010）、症状表现（p = 0.034）、动脉瘤大小（p = 0.000）以及糖尿病（p = 0.000）是显著的预后因素，而治疗方式不是。
结论
这项首次针对UIA的全国多中心调查展示了韩国UIA的流行病学和临床特征、治疗结果以及预后因素。韩国UIA术后30天的结果显示发病率和死亡率似乎较为合理。
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