伴破裂囊泡形成的颅内动脉瘤的血管内介入治疗  

Endovascular treatment of intracranial aneurysm with ruptured bleb formation

作　　者：于金录[1] 王宏磊[1] 许侃[1] 王柏[2] 方华[2] 罗祺[1] 

机构地区：[1]吉林大学白求恩第一医院神经外科,长春130021 [2]吉林大学白求恩第一医院放射线科,长春130021

出　　处：《中华神经外科杂志》2010年第11期988-991,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨伴破裂囊泡形成的颅内动脉瘤的血管内治疗特点.方法 回顾性分析2年间治疗的此类病例30例,将其分为Ⅰ～Ⅳ4型进行血管内介入治疗.预后采用GOS评分判定,各型间采用x2检验进行比较.并行DSA复查.结果 Ⅰ型及Ⅱ型的19例中,GOS评分5分18例、4分1例.Ⅲ型7例山,GOS评分5分6例、1分1例.Ⅳ型4例,GOS评分5分2例、1分2例.x2检验见预后：Ⅰ及Ⅱ型＞Ⅲ型＞Ⅳ型.所有病例随访至半年至1年时行DSA复查,未见动脉瘤再通.结论 伴破裂囊泡形成的颅内动脉瘤病例采用血管内治疗多能获得较好疗效.这其中以Ⅳ型的预后最差,Ⅲ型次之,Ⅰ及Ⅱ型最好.Objective To study our clinical experiences in endovascular treatment of intracranial aneurysm with ruptured bleb formation by using coil embolization in 30 patients.Method Between June 2007 and June 2009,30 patients presented aneurysms with ruptured bleb formation were treated.The aneurysms were classified into four types （ type Ⅰ,Ⅱ,Ⅲ,Ⅳ ） based on the relationships among the size of the neck of aneurysm connected with the parent artery,the size of the aneurysm body,and the size of the junction formed between the aneurysm and bled.We summarized the features of endovascular treatment for each type of aneurysm by coil embolization.Prognosis was determined by GOS.Statistical analysis of an intergroupx2 test was adopted.Results We found that coil embolization of type Ⅳ aneurysm was the most difficult to be performed,easily resulting in rupture and bleeding during surgery.Whereas embolization of type Ⅲ aneurysm was relatively simple.An intraoperative rupture could be caused not only by mechanical force made by the placement of stent or balloon at the neck of true aneurysm,but also by perioperative anticoagulation treatment.Prognosis was determined by statistical analysis of an intergroup x2 test （ P〈 0.01 ）.Type Ⅰ and Ⅱ aneurysms had better prognosis.Conclusions Good outcomes could be achieved by endovascular treatment for intracranial aneurysm with ruptured bleb formation,but only in a type depeudent manner.

关 键 词：顿内动脉瘤 破裂囊泡 血管内治疗 

分 类 号：R686[医药卫生—骨科学]