电解脱弹簧圈(GDC)在颅内动脉瘤腔栓塞治疗中的临床应用  

Clinical Application of the Embolization Therapy with Gugliulmi Detachable Coil(GDC) in Intracranial Aneurysms

作　　者：李明华 程英升 顾斌贤 陈君彦 方 淳 徐 涛[1] 刘建民[2] 许 奕[2] 周晓平[2] 洪 波[2] 赵文元[2] 

机构地区：[1]第二军医大学附属长海医院 [2]上海市第六人民医院,200233

出　　处：《中国医学计算机成像杂志》2002年第1期53-57,共5页Chinese Computed Medical Imaging

基　　金：本课题由上海市重点医学发展基金资助(98ZD003);上海市优秀学科带头人基金资助(00XD14020)

摘　　要：目的:评价颅内动脉瘤GDC栓塞术的效果和并发症。材料和方法:应用GDC栓塞治疗颅内动脉瘤270例273枚。其中5例在载瘤动脉内支架置放后再行瘤腔内GDC栓塞。临床表现为动脉瘤性蛛网膜下腔出血236例,脑神经压迫症状18例,其他16例。131例在栓塞后3～15个月作了随访血管造影。结果:262例265枚动脉瘤栓塞成功,8例手术失败。动脉瘤完全闭塞或几近完全闭塞（闭塞范围>95％）217枚,大部闭塞（闭塞范围70％～95％）31枚,部分闭塞（闭塞范围<70％）17枚,与手术相关的死亡4例,与手术相关的并发症18例（其中13例经处理后无后遗症;4例轻残;1例重残）。随访脑血管造影显示动脉瘤复发9例,均为原部分栓塞患者。结论:颅内动脉瘤腔内GDC完全致密填塞的效果肯定,与手术相关的并发症发生率与操作者经验有关。Purpose: To evaluate the efficacy and complication of embolization therapy with GDC in intracranial a-neurysms.Materials and Methods: 270 cases with 273 intracranial aneurysms were treated with GDC embolization.Of them, five cases were embolised by GDC following placing stents in the parent arteries . The clinical presentation consisted of aneurysmal subarachnoid hemorrhage in 236 cases, compression of cranial nerves in 18, other in 16. Follow - up cerebral angiography was performed between 3 months and 15 months after GDC embolization in 131 cases. Results:265 aneurysms in 262 cases were successfully embolised, with a total or near total occlusion(embolised area> 95%) in 217 aneurysms, a subtotal occlusion (embolised area 70%～95%) in 31 and a partial occlusion(embolised area< 70%) in 17.In 8 cases the procedure failed Procedure related deaths occurred in 4 cases and complication in 18 cases(no neurologic defect in 13 cases with post - embolization therapy, mild neurologic defect in 4, and severe neurologic defect in one). Recurrences of partially occluded aneurysms were shown in 9 cases on follow - up cerebral angiography. Conclusion: A total and dense embolization with GDC in intracranial aneurysm is very important for clinical efficacy. The incidence of complication is related to the experience of operator.

关 键 词：颅内动脉瘤 栓塞 GDC 血管内治疗 并发症 

分 类 号：R739.41[医药卫生—肿瘤]