超早期介入栓塞治疗颅内动脉瘤破裂致Ⅰ~Ⅲ级蛛网膜下腔出血疗效分析  

Clinical analysis of gradeⅠ-Ⅲsubarachnoid hemorrhage caused by ultra-early interventional embolization for intracranial aneurysm rupture

作　　者：陈新华[1] 周仕钧[1] 彭海峰[1] 杨旭波[1] 喻小玲[1] CHEN Xin-hua;ZHOU Shi-jun;PENG Hai-feng;YANG Xu-bo;YU Xiao-ling(Department of Neurology,Xiangtan First People's Hospital,Xiangtan411101,P.R.China)

机构地区：[1]湘潭市第一人民医院神经内科,湖南湘潭411101

出　　处：《社区医学杂志》2020年第3期187-190,共4页Journal Of Community Medicine

摘　　要：目的目前介入栓塞已成为治疗破裂颅内动脉瘤首选方法。本研究探讨超早期介入栓塞破裂颅内动脉瘤治疗Hunt-Hess分级Ⅰ~Ⅲ级蛛网膜下腔出血的近期疗效。方法选取2010-09-10-2018-10-11湘潭市第一人民医院收治的90例Hunt-Hess分级Ⅰ~Ⅲ级动脉瘤破裂蛛网膜下腔出血患者为研究对象,均行超早期动脉瘤介入栓塞治疗,6个月后以格拉斯哥结局量表(Glasgow outcome scale,GOS)预后评分分级为指标进行疗效评估。结果90例患者中,弹簧圈单纯致密栓塞34例,椎动脉动脉瘤行椎动脉闭塞4例,支架辅助弹簧圈栓塞52例。所有患者中,1例术中动脉瘤再次破裂出血,2例术后<1周死亡,术中脑血管痉挛5例,术后脑梗死2例。影像学随访70例,2例复发;共随访85例,完全康复77例。结论超早期介入栓塞是治疗破裂颅内动脉瘤Hunt-Hess分级Ⅰ~Ⅲ级蛛网膜下腔出血较理想的方法。OBJECTIVE Current interventional embolization has become the preferred method for the treatment of rupture intracranial aneurysm.This study investigates the short-term efficacy and popularization value of ultra-early interventional embolization and rupture of intracranial aneurysms in the treatment of Hunt-Hess gradeⅠ-Ⅲsubarachnoid hemorrhage.METHODS A total of 90 patients with Hunt-Hess gradeⅠ-Ⅲaneurysm rupture subarachnoid hemorrhage admitted to Xiangtan First People’s Hospital from September 10,2010 to October 11,2018 were treated with ultraearly aneurysm interventional embolization,6 months after the treatment,the Glasgow outcome scale(GOS)prognostic score was used as an indicator to evaluate the efficacy.RESULTS Of the 90 patients,34 patients underwent simple embolization with a coil,4 patients underwent vertebral artery occlusion with vertebral artery aneurysm,and 52 patients underwent stent-assisted coil embolization.Among the patient,1 case had an intraoperative aneurysm rupture again,2 cases died within one week after surgery,5 cases had intraoperative cerebral vasospasm,and 2 cases had postoperative cerebral infarction.There were 70 cases of imaging follow-up,and 2 cases had recurrence.Eighty five cases were followed up clinically and 77 cases were completely recovered.CONCLUSION Ultra-early interventional embolization is an ideal method for the treatment of ruptured intracranial aneurysms with Hunt-Hess gradeⅠ-Ⅲsubarachnoid hemorrhage.

关 键 词：颅内动脉瘤 介入栓塞 HUNT-HESS分级 超早期 

分 类 号：R743.35[医药卫生—神经病学与精神病学]