头颈部创伤性假性动脉瘤的治疗(附26例报告)  

Treatment of traumatic pseudoaneurysms of head and neck (report of 26 cases)

作　　者：蔡明俊[1] 潘力[1] 马廉亭[1] 杨铭[1] 徐国政[1] 李俊[1] 陈刚[1] 伍杰[1] 

机构地区：[1]广州军区武汉总医院神经外科,武汉430070

出　　处：《中国临床神经外科杂志》2013年第4期193-196,共4页Chinese Journal of Clinical Neurosurgery

基　　金：中国博士后科学基金面上资助项目(No:201104901915)

摘　　要：目的探讨头颈部创伤性假性动脉瘤的治疗方法及其效果。方法回顾性分析我院2006年9月到2012年3月收治的26例头颈部创伤性假性动脉瘤病人的临床资料。手术治疗4例，血管内治疗19例，保守治疗3例。结果手术治疗的4例患者均恢复良好。血管内治疗的19例患者，术后即刻行DSA检查显示假性动脉瘤均消失，未发生脑梗死。保守治疗的3例患者，1例初次DSA检查后22d再次行DSA检查显示原有假性动脉瘤消失，载流动脉通畅；另外2例患者家属拒绝外科治疗，最终死于动脉瘤破裂出血。24例患者出院后随访6～24个月，1例出现支架旁动脉瘤复发，其余患者未见复发或神经功能缺失表现。结论头颈部创伤性假性动脉瘤应针对其部位及特点，选择相应的的外科治疗方法；血管内治疗是其首选方法，安全、有效。Objective To explore the treatment of traumatic pseudoaneurysms of head and neck and its clinical effecct. Methods The clinical data of 26 patients with traumatic pseudoaneurysms of head and neck, who were treated in our hospital from September, 2006 to March, 2012, were analyzed retrospectively. Of 26 patients, 4 received neurosurgical treatment, 19 received endovascular treatment and 3 conservative treatment. Results Four patients undergoing the neurosurgical treatment were recovered well. DSA immediately after the endovascular treatment showed that all the pseudoaneurysms disappeared and no cerebral infarction occurred in 19 patients receiving endovascular treatment. DSA reperformed 22 days after the first DSA examination showed that the pseudoaneurysm disappeared in 1 patient receiving conservative treatment. Two patients receiving conservative treatment died of rebleeding of the pseudoaneurysm. Of 24 patients followed up for 6-24 months after discharge from hospital, 1 receiving the endovascular treatment had recurrent pseudoaneurysm, and 23 had no neurological deficit. Conclusions The treatment of traumatic pseudoaneurYsms of head and neck should be selected according to the locations and features of the pseudoaneurysms. The endovascular treatment is a safe and effective method and should be the first choice for treatment of traumatic pseudoaneurysms.

关 键 词：颅脑损伤 假性动脉瘤 头颈部 治疗 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R815[医药卫生—临床医学]