小型颅内动脉瘤的临床特点及血管内栓塞治疗  

The clinical feature and endovascular embolization therapy with coils in minitype intracranial aneurysms

作　　者：宋锦宁[1] 刘守勋[1] 鲍刚[1] 王拓[1] 刘晓斌[1] 陈景宇[1] 张晓东[1] 徐高峰[1] 谢昌厚[1] 

机构地区：[1]西安交通大学医学院第一附属医院神经外科,710061

出　　处：《中华神经外科杂志》2007年第12期925-928,共4页Chinese Journal of Neurosurgery

基　　金：国家高技术研究发展计划"863计划"资助课题(2006AA02Z4Z4);教育部高层次创造性人才计划<新世纪优秀人才支持计划>资助课题(NCET-05-0831);陕西省科学技术研究发展攻关计划基金资助项目(2002K10-G1-9)

摘　　要：目的总结小型颅内动脉瘤的临床特点以及血管内栓塞的技术要点与疗效。方法对45例小型颅内动脉瘤患者采用电解可脱性弹簧圈(GDC)或Trufill DCS Orbit微型三维填塞型水解铂金弹簧圈进行动脉瘤囊内栓塞。结果45个动脉瘤中41个瘤腔100%闭塞,3个95%闭塞,1个90%闭塞。术后44例临床痊愈,其治疗结果根据Glasgow预后评分:Ⅰ级29例,Ⅱ级11例,Ⅲ级3例,Ⅳ级1例,Ⅴ级1例;全组死亡率2.2%。栓塞术中并发脑血管痉挛6例。术后随访3-69个月均无再出血及复发。结论对小型颅内动脉瘤采用GDC或Truffill DCS Orbit微型三维填塞型水解铂金弹簧圈进行血管内囊内栓塞疗效可靠;根据小型颅内动脉瘤的临床特点进行栓塞是提高治愈率、降低并发症及死亡率的重要方法。Objective To summarize the clinical feature and techniques of minitype intracranial aneurysm with Guglielmi detachable coils （GDC） or Trufill DCS Orbit, and to evaluate the effect of treatment. Methods A total of 45 cases with minitype intracranial aneurysm were treated with GDC or Trufill orbit to embolize the aneurismal sac. Results All 45 patients were cured, in which 44 cases recovered clinically. According to the Glasgow prognosis score, the therapeutic efficacy was that： 29 patients were in grade Ⅰ, 11 cases were grade Ⅱ , 3 cases were grade Ⅲ, 1 cases were grade Ⅳ, 1 cases were grade Ⅴ. The morality rate was 2.2%. The sac of 41 aneurysms were achieved 100% embolization, 3 with 95% embolization, 1 with 90% embolization. Aneurysms had not reputured during the embolization. 6 case happened cerebral vasospasm. No re-bleeding and recurring occurred in the 3-to-69-month follow-up. Conclusion The endovascular embolization is a safe and effective treatment for the minitype intracranial aneurysm with GDC or Trufill DCS Orbit. According to clinical feature to embolism minitype intracranial aneurysm are important methods to improve the curative rate.

关 键 词：颅内动脉瘤 血管内栓塞 电解可脱性弹簧圈 水解铂金弹簧圈 

分 类 号：R651.12[医药卫生—外科学]