超早期支架辅助栓塞治疗颅内宽颈动脉瘤破裂的即时栓塞效果及围术期并发症发生率分析  

Analysis of immediate embolization effect and perioperative complication rate of ultra-early stent-assisted embolization for ruptured intracranial wide-necked aneurysm

作　　者：陈唯实 邓智峰 徐建基 CHEN Wei-shi;DENG Zhi-feng;XU Jian-ji(Department of Neurosurgery,Taishan People’s Hospital,Taishan 529200,China)

机构地区：[1]台山市人民医院神经外科,529200

出　　处：《中国实用医药》2021年第11期34-36,共3页China Practical Medicine

基　　金：江门市科技计划项目(项目编号:2020020200170001089)。

摘　　要：目的探讨超早期支架辅助栓塞治疗颅内宽颈动脉瘤破裂的即时栓塞效果及围术期并发症发生率。方法30例颅内宽颈动脉瘤破裂患者,采用侧脑室穿刺术测脑室内压力,后行超早期支架辅助栓塞治疗、围术期处理以及术后措施。观察患者即时栓塞效果、并发症发生率及跟踪随访结果。结果术后即时进行数字减影血管造影技术(DSA)检查,RoyRaymondⅠ级28例(93.33%),RoyRaymondⅡ级2例(6.67%);2例患者出现围术期并发症(6.67%),均为术中出血。其中1例死亡(3.33%),无缺血并发症;1例大脑前交通动脉宽颈动脉瘤随访期间1次复发,该患者于首次手术治疗后3个月时发现,再行弹簧圈补充栓塞治疗,术后改用单抗治疗。术后半年随访改良Rankin量表(MRS)评分0分。有20例未出现动脉瘤复发。结论超早期支架辅助栓塞治疗颅内宽颈动脉瘤破裂,可提升即时栓塞效果,降低围术期并发症发生率。Objective To discuss the immediate embolization effect and perioperative complication rate of ultra-early stent-assisted embolization for ruptured intracranial wide-necked aneurysm.Methods 30 patients with ruptured intracranial wide-necked aneurysm were treated with intraventricular puncture to measure the intraventricular pressure,and then with ultra-early stent-assisted embolization,perioperative management and postoperative measures.The immediate embolization effect,incidence of complications and follow-up results were observed.Results Digital subtraction angiography(DSA)examination was performed immediately after operation.There were 28 cases(93.33%)of RoyRaymondⅠand 2 cases(6.67%)of RoyRaymondⅡ;2 patients(6.67%)had perioperative complications,both of which were intraoperative bleeding.Among them,1 case(3.33%)died without ischemic complications;1 case of anterior communicating artery wide-necked aneurysm recurred once during the follow-up period.The patient was discovered 3 months after the first surgical treatment,and then received supplemental coil embolization therapy,and switched to monoclonal antibody therapy after the surgery.The modified Rankin scale(MRS)score was 0 in the follow-up six months after the operation.There were no recurrence of aneurysm in 20 cases.Conclusion Ultra-early stent-assisted embolization for ruptured intracranial wide-necked aneurysm can improve the immediate embolization effect and reduce perioperative complication rate.

关 键 词：支架辅助栓塞 颅内宽颈动脉瘤破裂 即时栓塞效果 并发症 

分 类 号：R651.12[医药卫生—外科学]