30例脑动脉瘤患者的可脱弹簧圈治疗  

Embolization with detachable coils in treatment of cerebral aneurysms:report of 30 cases

作　　者：蔡涛[1] 陈丽静[1] 陈国明[1] 宋志惠[1] 徐子明[1] 潘力雄[1] 李少鹏[1] 宋敏鹰[1] 付万新[1] 刘锡川[1] 

机构地区：[1]广东省东莞市人民医院神经外科,523018

出　　处：《中华神经医学杂志》2006年第6期615-617,共3页Chinese Journal of Neuromedicine

摘　　要：目的评价使用可脱卸铂弹簧圈(GDC、EDC、DCS)栓塞治疗脑动脉瘤的临床效果,分析可脱卸弹簧圈栓塞治疗急性破裂出血动脉瘤过程中脑血管痉挛的发生及处理办法。方法血管内栓塞治疗Hunt-HessⅠ-Ⅲ级动脉瘤病人30例,6例患者同时加用腰穿放置腰椎蛛网膜下腔持续引流,观察栓塞效果及症状性血管痉挛的发生情况。结果本组病人共发生症状性血管痉挛4例,而6例腰穿置管患者无一发生血管痉挛。所有患者随访1～24个月,4例发生症状性脑血管痉挛病人中中度致残2例,其余病人恢复良好。结论血管内栓塞是治疗脑动脉瘤较理想的方法,具有微创、安全可靠、效果确切的特点。腰穿放置腰椎蛛网膜下腔持续引流可能对降低症状性脑血管痉挛的发生有积极意义。Objective To evaluate the efficacy of endovascular embolization with detachable coils （GDC, EDC, DCS） in cerebral aneurysms, and analyze the incidence and treatment of cerebral vasospasm during early endovascular therapy of acute ruptured aneurysms with detachable coils. Methods 30 patients classified as Hunt-Hess Ⅰ - Ⅲ grade to be treated with detachable coils, and of them 6 patients were subjected to continuous subaractmoid drainage through lumber puncture at the same time. The outcomes of embolization and the incidence of symptomatic vasospam were observed. Results Symptomatic vasospasm occurred in 4 patients, not including anyone treated with continuous lumber subarachnoid drainage. During a follow-up of 1-24 months, 28 patients recoverd well, and the other 2 patients who had symptomatic vasospasm were moderately disabled. Conclusion Endovascular embolization with detachable coils is a minimally invasive, safe, effective and reliable method for treating cerebral aneurysms. Continuous cerebral spinal fluid drainage through lumber puncture may play an important role in reducing the incidence of cerebral vasospasm.

关 键 词：可脱卸弹簧圈 脑动脉瘤 脑血管痉挛 蛛网膜下腔出血 血管内治疗 

分 类 号：R651.12[医药卫生—外科学]