可脱性球囊介入治疗急症创伤性颈内动脉海绵窦瘘临床研究  

Treatment of acute traumatic carotid-cavernous fistula (TCCF) with interventional detachable balloon

作　　者：零达尚[1] 刘远来[1] 王海东[2] 黄理金[3] 

机构地区：[1]南方医科大学附属小榄医院神经外科,广东中山528415 [2]厦门市第一医院神经外科,福建厦门361003 [3]南方医科大学附属南方医院神经外科,广东广州510515

出　　处：《临床和实验医学杂志》2009年第11期46-47,49,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的总结可脱性球囊介入治疗急症创伤性颈内动脉海绵窦瘘的经验。方法对2005年9月至2008年3月共12例急性外伤性颈内动脉海绵窦瘘行可脱性球囊治疗病例进行回顾性分析。结果本组病例12例成功栓塞,保持颈内动脉通畅9例,术后鼻出血、颅内杂音、搏动性突眼症状均消失,术后3d复发1例,第二次手术再次放入一枚球囊治愈,术后视力障碍均得到不同程度改善,手术越早改善越明显。结论合并有大量鼻腔出血、视力急剧恶化及脑皮层引流的外伤性颈内动脉海绵窦瘘是急症手术治疗的指征,可脱性球囊栓塞治疗凭借其快捷方便、价格低廉等优势,目前仍为首选治疗方法。Objective To summarise the clinical experience of the interventional treatment for the acute traumatic carotid-cavernous fistula（TCCF）with detachable balloon.Methods Twelve cases of acute TCCF treated with interventional detachable balloon from Sep.2005 to Mar.2008 were analyzed retrospectively.Results All the 12 cases were embolized successfully.Among these csases,9 cases had unobstructed arteria carotis interna,and haemorrhagia,intracranial artery bruit and pulsating exophthalmos disappeared after occlusion of the fistula.But recurrence happened in one case on the 3rd day after the procedure,and cured by re-embeded another balloon.In these cases visual disturbance improved at different extent,and it was found that the sooner the operation,the better the revovery.Conclusion TCCF accompanied with severe nose bleeding,visual deterioration and brain cortex drainage should be treated emergently.The embolism with detachable balloons is still the first choice for the treatment of acute TCCF due to its efficiency,convenience and low cost.

关 键 词：球囊 介入治疗 颈内动脉 海绵窦瘘 

分 类 号：R651.12[医药卫生—外科学]