微血管多普勒超声联合吲哚菁绿造影在老年动脉瘤性蛛网膜下腔出血患者显微手术夹闭中的应用  

The Application of Combined Microvascular Doppler Ultrasonography and Indocyanine Green Angiography in Microsurgical Clipping for Elderly Patients with Aneurysmal Subarachnoid Hemorrhage

作　　者：王俊[1] 孙而艺 陈宇超 周洲 陈波[1] WANG Jun;SUN Er-yi;CHEN Yu-chao;ZHOU Zhou;CHEN Bo(Department of Neurosurgery,People’s Hospital of Jiangsu University,Zhenjiang 212002,China)

机构地区：[1]江苏大学附属人民医院神经外科,江苏镇江212002

出　　处：《实用临床医学(江西)》2025年第1期34-38,共5页Practical Clinical Medicine

基　　金：镇江市科技创新基金(SH2021046)。

摘　　要：目的 探讨微血管多普勒超声(microvascular doppler ultrasonography,MDU)联合吲哚菁绿造影(indocyanine green angiography,ICGA)在老年动脉瘤性蛛网膜下腔出血患者显微手术夹闭术中的安全性及可靠性。方法 回顾性分析接受动脉瘤显微手术夹闭的41例老年动脉瘤性蛛网膜下腔出血患者的临床资料,所有患者均在手术过程中使用了MDU和ICGA监测技术。结果 41例患者中,共有12例出现载瘤动脉/穿支动脉狭窄或动脉瘤颈夹闭不全/瘤颈残留,其中9例进行了1次动脉瘤夹位置的调整,另外3例进行了2次调整。术后CT血管造影(CT angiography,CTA)检查均未发现动脉瘤体显影和载瘤动脉的闭塞或狭窄,1例患者发现有动脉瘤颈的残留。结论 MDU联合ICGA对进行显微手术夹闭治疗的老年动脉瘤性蛛网膜下腔出血患者具有较高的安全性及可靠性。Objective To investigate the safety and reliability of microvascular Doppler ultrasonography(MDU)combined with indocyanine green angiography(ICGA)in microsurgical clipping for elderly patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods Clinical data from 41 elderly aSAH patients undergoing microsurgical aneurysm clipping were retrospectively analyzed.Intraoperative MDU and ICGA monitoring were systematically applied in all cases.Results Among the 41 patients,12 exhibited parent artery/perforator artery stenosis or incomplete aneurysm neck clipping/residual neck.Adjustments of clip positions were performed once in 9 cases and twice in 3 cases.Postoperative CT angiography revealed no aneurysm sac opacification,parent artery occlusion or stenosis,except for 1 case of residual aneurysm neck.Conclusion The combined application of MDU and ICGA can demonstrate favorable safety and reliability in elderly patients with aneurysmal subarachnoid hemorrhage undergoing microsurgical clipping.

关 键 词：动脉瘤性蛛网膜下腔出血 老年 微血管多普勒超声 吲哚菁绿 夹闭 

分 类 号：R615[医药卫生—外科学]