颅内动脉瘤弹簧圈栓塞术中出血的原因分析和防治  

Analysis of the Causes, Prevention and Treatment of Hemorrhage During Coil Embolization for Intracranial Aneurysm

作　　者：肖兵[1] 宋建琼[2] 刘春平[3] 刘谊[4] 蔡洪[4] 陈忠[4] 

机构地区：[1]达州市中心医院介入科,四川达州635000 [2]达州市中心医院功能科,四川达州635000 [3]达州市中心医院神经内科,四川达州635000 [4]达州市中心医院神经外科,四川达州635000

出　　处：《华西医学》2013年第3期334-337,共4页West China Medical Journal

摘　　要：目的分析颅内动脉瘤弹簧圈栓塞治疗术中出血的原因和防治对策。方法回顾性分析2003年3月-2012年8月358例颅内动脉瘤采用弹簧圈栓塞治疗患者,7例弹簧圈栓塞过程中出血,并继续栓塞止血。2例为弹簧圈栓塞中造影仅见血流明显变慢,术后CT证实的出血。术后对症治疗6例,开颅引流减压3例。结果 9例术中破裂者中8例致密栓塞,1例部分栓塞。5例恢复好,1例一过性动眼神经麻痹,3例死于颅内高压结论术中出血与手中操作、动脉瘤形态和患者血管条件、血压变化有关,继续填塞及合理术中与后续治疗可以挽救大部分患者生命。Objective To analyze the causes,prevention and treatment of hemorrhage during coil embolization for intracranial aneurysm.Methods We retrospectively analyzed the clinical data of 358 patients with intracranial aneurysm treated with coil embolization.Among them,seven patients had hemorrhage during the procedure and were continuously embolized until the bleeding was halted;Another two whose blood flow was slowed down were identified by post-procedure CT.Results Among the nine hemorrhage patients,eight underwent complete embolization,and the one underwent partial embolization.Five patients recovered well;one suffered from transient oculomotor nerve palsy;and another three patients died of hyper intracranial pressure within three days.Conclusions Hemorrhage during procedure of intracranial aneurysm embolization may be related to manipulation,aneurysm form,properties of the parent artery and aneurysm,and blood pressure changes.Continuous embolization with coil and reasonable treatment provides favorable prognosis for the patients.

关 键 词：颅内动脉瘤 弹簧圈 栓塞 术中出血 

分 类 号：R743[医药卫生—神经病学与精神病学]