脑血管病血管造影的诊断及介入治疗的临床应用

目的探讨DSA在脑血管病因诊断中及血管内介入治疗中的应用价值。方法回顾性分析430例不同脑血管病的DSA阳性检出率、安全性及临床特点，对颈动脉狭窄，部分脑动脉瘤，脑血管畸形进行血管内介入栓塞的疗效评价。结果所有受检者无1例发生永久性神经功能缺损。总的DSA阳性检出率高（66．74％），其中缺血性脑血管病阳性率最高（82．85％），主要血管病变为脑动脉粥样硬化性狭窄或闭塞，颅外段受累多见。其次为蛛网膜下隙出血（65．04％）、脑实质出血（52．77％）、单侧动眼神经麻痹（66．66％）、头痛待诊（43．47％）阳性率也高，但总患者数尚少。症状性癫痫的DSA结果均为阴性。结论规范化操作可充分保障DSA检查的安全性。慎重筛查DSA纳入患者可提高DSA的阳性检出率及提高效率／费用比，有效指导二级预防治疗，血管内介入治疗具有疗效好，安全性高，创伤小等优点。

Clinical applicatiion of digital subtraction angiography(DSA)in the diagnosis and treatment interventional of cerebrovascular dlseases

Objective To investigate the diagnostic and treatment value of DSA and interventional treatment for cerebrovascular diseases.Methods Analyze percentage of positive findings,the safety and the clinical feature on DSA with cerebrovascular diseases. Values of interventional treatment for carotid artery stenosis and intracranial aneurysms and intracranial vascular malformation. Results nobody suffer permanent neurologic deficits of 130 eases, The positive findings of the 430 patients was higher （ 66.74 % ） , especially the ischemic cerebrovasealar diseases was highest （82.85%）, the main pathology was intra-and extracranial cerebralartery stenosis in patient with atherosclerosis, mostly in the extraeranial portion of carotid artery, the second was subarachnoid hemorrhage （65.04%）.The positive fmdings of the patients with cerebral bemorrhages （52.77%）. unknown headache （43.47%）, oculomotor nelve palsy （66.66%） was higher too, hut our cases was limited, no abnorlnality was revealed on DSA of 3 cases with epilepsy. Conelusion Standardize operation can fully ensure the safety of DSA inspection. Sift carefully cases for DSA can raise the positive findings of DSA, the ratio of efficiency/cost, and effective guide the secondary prevention of cerebral infarction, lnterventional embolization treatment is a safe, satisfaetive effective, mini-invasive therapy.