超早期栓塞颅内破裂动脉瘤的技术利弊

目的:通过比较超早期(发病6h内)和其它时间段栓塞颅内破裂动脉瘤的治疗效果,探讨超早期栓塞动脉瘤的技术利弊。方法:对自发性蛛网膜下腔出血患者尽可能早地进行全脑血管造影,发现动脉瘤则行GDC栓塞。其中2例患者的治疗时间在出血后6h以内,1例仅在出血后2h开始介入栓塞治疗。结果:出血后超早期行栓塞的2例患者均因术中二次破裂出血而术后死亡,在出血后6h之后进行栓塞的27例患者中1例死亡,2例残疾,其余24例均获得较好的恢复。结论:超早期栓塞治疗动脉瘤对技术提出了较高的要求,开展超早期栓塞治疗动脉瘤须结合自身技术水平,充分认识其中的风险。

Technical Advantage and Disadvantage of Embolization of Ruptured Aneurysm in Super Early Stage

Objective:To discuss the advantage and disadvantage of the embolization of acute aneurismal rupture by comparing results of coiling between within 6 hours and after.Method:29 patients of subarcnoid haemorrhage were diagnosised as aneurysm by angiography,and were embolized with GDC.2 patients were treated within 6 hours,the earliest one was coiled in only 2 hours after the rupture.Results:The two embolizations within 6 hours induced postoperational death because procedural rebleeding,and other 27 cases achieved much better recovery.The mortality ratio was 100% with embolization (<6hours) and 4% (>6hours).Conclusion:Embolization of the ruptured aneurysms in the early stage (<6hours)carries much greater risks than the late stage treatment (>6hours).It should be individualized according to the skill level of yourself and the technique available.