血管内栓塞治疗颅内动脉瘤时间窗的临床评价  

Clinical evaluation of timing of endovascular embolization treatment for intracranial aneurysm

作　　者：张洪涛[1] 吴鑫[1] 陈永安[1] 崔广强[1] 潘树茂[1] 

机构地区：[1]山东烟台毓璜顶医院神经外科,264000

出　　处：《中华神经外科杂志》2011年第4期466-468,共3页Chinese Journal of Neurosurgery

基　　金：山东烟台市科学技术发展计划项目（2008142-10）

摘　　要：目的 评价不同时间窗内对动脉瘤患者进行血管内治疗的效果,探讨早期血管内治疗能否改善动脉瘤患者的预后.方法 回顾性分析165例血管内治疗动脉瘤破裂出血患者的临床资料,按手术至发病时间不同分为3组：A组在出血后24 h内进行治疗;B组在手术至出血时间为24 h-3 d进行治疗;C组在3 d后进行治疗.比较分析各组患者预后及主要并发症的发生率,包括再出血、脑积水及脑血管痉挛.结果 早期及超早期治疗组再出血、脑血管痉挛及脑积水等主要并发症的发生率明显低于延期治疗组（P＜0.01）;延期治疗组患者脑血管痉挛发生的程度最严重,持续时间最长,早期治疗组次之,而在24 h内得到治疗的患者,脑血管痉挛可以控制在较低水平,持续时间亦明显缩短;无论轻型或重型患者,早期治疗组预后评分均显著高于延期治疗组.结论 早期血管内介入治疗能明显降低动脉瘤性蛛网膜下腔出血患者的并发症发生率,改善患者预后.Objective To evaluate the effects of endovascular embolization treatment for intracranial aneurysms in different time. Methods To respectively analyse the clinical data of 165 cases of ruptured intracranial aneurysm treated by endovascular treatment. The patients were divided into 3 groups accrodding to the time of treatment, endovascular reatments were stated within 24 h in group A, 3 d in group B and after 3 d in group C. The outcomes and complications including rebleeding, vasospasm and hydrocephala of 3 groups were compared. Results The incidence of rebleeding, vasospasm and hydrocephala in group A and B were lower than that in group C （ P 〈 0. 01 ）. Vasospasm in group C was most severe. The GOS score was highest in group A and lowest in group C. Conclusion Endovascular embolization treatment is a safe and effective method for treatment of intracranial aneurysm. The timing of treatment is a major factor for technical success.

关 键 词：颅内动脉瘤 血管内治疗 栓塞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]