外伤性颈内动脉海绵窦瘘的栓塞治疗和TCD监测  

Embolization Therapy and TCD Monitoring of Traumatic Carotid Cavernous Fistula

作　　者：杜仁法[1] 孙红卫[1] 保建基[1] 

机构地区：[1]郑州市河南医科大学一附院神经外科

出　　处：《中国超声医学杂志》1999年第8期578-580,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的：评价国产钨丝螺旋圈栓塞颈内动脉海绵窦瘘的疗效和栓塞前后ＴＣＤ监测的价值。方法：在神经安定麻醉下经右股动脉插管，脑血管造影证实后，微导管进入瘘口内，用２～４ｃｍ长钨丝螺旋圈栓塞至自觉血管杂音消失，海绵窦不再显影时结束操作，并于栓塞前后应用ＴＣＤ监测颈内动脉、大脑中动脉和大脑前动脉、大脑后动脉血流速度。结果：２３例１次成功，１例２次成功。无并发症发生。栓塞前患侧ＩＣＡ流速增加，ＭＣＡ、ＡＣＡ流速降低（１例ＡＣＡ信号翻转），压闭患侧颈内动脉后，所有ＡＣＡ血流信号翻转，ＰＣＡ血流增快，提示脑底动脉环功能良好。栓塞后患侧ＩＣＡ流速降低，而ＡＣＡ和ＭＣＡ流速加快，提示瘘口消失，脑供血改善。结论：国产钨丝螺旋圈价格低廉，易操作，且颈动脉通畅率高，可作为颈内动脉海绵窦瘘的首选栓塞材料。栓塞前应用ＴＣＤ监测可粗略估计瘘口大小及侧枝循环情况，栓塞后可作为评价疗效的一种观察指标。Objective and Methods:To evaluate the effect of embolization therapy for traumatic carotid cavernous fistula(TCCF)and TCD monitoring the velocity of internal carotid artery,the ACA,the MCA,and the PCA. Results: 23 patients were recovered by at once performance,one patient at twice,no complication occurred.The reversed ACA flow signal and the increased PCA velocity induced by pressing the carotid artery indicated good function of the basal artery circle.The decreased velocity of the affected ICA and increased ACA and MCA indicated the disappearing of fistula and improving cerebral blood supply. Conclusion: Intravascular embolization is a favourable TCCF treatment method.

关 键 词：颈内动脉 海绵窦瘘 血管内栓塞 多普勒超声 TCD 

分 类 号：R543.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]