Hunt-HensⅤ级颅内动脉瘤的早期介入栓塞治疗  

Early endovascular embolization for the treatment of Hunt-Hens Ⅴ ruptured intracranial aneurysms

作　　者：郄福忠[1] 肖玉强[1] 马光涛[1] 

机构地区：[1]黑龙江省大庆油田总医院神经外科,163001

出　　处：《介入放射学杂志》2011年第11期841-843,共3页Journal of Interventional Radiology

摘　　要：目的探讨早期介入栓塞治疗Hunt-HensⅤ级颅内动脉瘤的可行性。方法回顾性分析2000年9月至2010年10月收治的31例Hunt-HensⅤ级颅内动脉瘤患者的临床资料和早期经血管内介入栓塞治疗的疗效。31例患者均在入院3 d内(其中19例24 h内)行介入治疗,动脉瘤直径2.7～12.7 mm。介入治疗后行脑室外引流术5例,气管切开术23例,腰池引流术18例,血肿清除去骨瓣减压术7例。术后随访6个月。结果 31例患者共发现32个动脉瘤,治疗31个,行动脉瘤致密栓塞25例,次致密栓塞6例。31例中死亡8例(25.8%),重残9例,植物状态生存4例,良好4例,轻残6例。出现脑积水16例,行脑室腹腔分流术10例。结论对Ⅴ级颅内动脉瘤患者应早期行介入栓塞,为进一步防治严重并发症创造条件。Objective To discuss the feasibility of early endovascular embolization for the treatment of Hunt-Hens V ruptured intracranial aneurysms.Methods A total of 31 cases with Hunt-Hens V intracranial aneurysms encountered in the period from Sep.2000 to Oct.2010 were enrolled in this study.The clinical data and the therapeutic results were retrospectively analyzed.Thirty-one patients received interventional treatment within three days including 19 within 24 hours after adinission,The diameter of the aneurysms was（2.7-12.7） mm.After endovascular embolization,external ventricular drainage（n = 5）,tracheotomy（n = 23）,lumbar puncture drainage（n = 18） and/or evacuation of hematoma（n = 7） was,when needed,further employed.All patients were followed up for 6 months.Results A total of 32 intracranial aneurysms were detected in 31 patients.Interventional endovascular embolization was performed for 31 lesions.Compact embolization of intracranial aneurysm was used in 25 cases,and sub-compact embolization of intracranial aneurysm was adopted in 6 cases.Of the 31 patients,death occurred in 8（25.8%） and severe disability was seen in 9（29.0%）,vegetable state in 4（12.9%）,good condition in 4（12.9%）,mild disability in 6（19.4%）.Hydrocephalus developed in 16 cases and establishment of ventricle-to-abdomen shunt was performed in 10 cases.Conclusion For the treatment of Hunt-Hens V ruptured intracranial aneurysms,endovascular embolization should be carried out as early as possible in order to prevent the occurrence of severe complications.

关 键 词：颅内动脉瘤 血管内介入治疗 

分 类 号：R651.1[医药卫生—外科学]