颅内动脉瘤栓塞术中突发性颈内动脉闭塞性痉挛的紧急处理  

Emergent treatment for sudden occlusive carotid artery spasm in embolization of intracranial aneurysms

作　　者：李巧玉[1] 陆陪松[1] 袁志诚[1] 湛利平[1] 王鹏[1] 张焱[1] 陆新宇[1] 陈波[1] 许文林[1] 

机构地区：[1]江苏大学附属人民医院神经外科,镇江市212008

出　　处：《江苏医药》2011年第7期817-820,共4页Jiangsu Medical Journal

摘　　要：目的总结颅内动脉瘤栓塞术中突发性颈内动脉闭塞性痉挛的紧急处理。方法 681例颅内动脉瘤栓塞术中,14例发生颈内动脉闭塞性痉挛。早期的8例采用经导引导管灌注罂粟碱和尿激酶等常规治疗方法处理;后期的6例采用动脉内灌注利多卡因和尿激酶等。结果常规方法治疗的8例中,仅5例痉挛部分解除,均未完成栓塞。采用利多卡因治疗的6例中,痉挛完全解除5例,4例完成栓塞,恢复正常。结论颈内动脉闭塞性痉挛常规治疗效果极差,采用利多因动脉内灌注可取得较好效果。Objective To summarize the outcomes of emergent treatment of sudden carotid artery occlusive spasm during embolization for intracranial aneurysm.Methods Of 681 patients received intracranial aneurysm embolization,carotid artery occlusive spasm occurred in 14 cases.Papaverine and urokinase were perfused by guiding catheter in 8 cases（group A） and arterial infusion of lidocaine and urokinase was performed in 6 cases（group B）.Results The spasm was partially attenuated in 5 cases and staied in 3 cases in group A.The embolization was not performed in all 8 cases in group A.The spasm in group B was completely relieved in 5 cases and intracranial aneurysm embolization was successful in 4 cases.Conclusions The efficacy of conventional treatment for carotid artery occlusive spasm is poor,which can be improved with arterial infusion of lidocaine.

关 键 词：颅内动脉瘤 颈内动脉痉挛 利多卡因 

分 类 号：R743[医药卫生—神经病学与精神病学]