血管内治疗症状性脑血管痉挛的临床研究

目的 观察血管内治疗症状性脑血管痉挛（SCVS）临床疗效。方法 应用经皮血管成形术（PTA）和超选择动脉内灌注罂粟碱（IAP）治疗5例动脉瘤夹闭术后SCVS病人。结果 4例在SCVS出现2h以内进行治疗的病人均取得满意疗效。1例在SCVS后10h进行IAP PTA治疗，疗效欠佳，留有中等程度的残疾。结论 IAP和PTA为临床治疗SCVS提供了新的方法，SCVS发生后尽早进行血管内治疗以取得满意的疗效。

Clinical study for symptomatic cerebral vasospasm treated by endovascular therapy

Objective To observe the treatment effect for cerebral vasospasm by endovascular therapy. Methods Five patients with subarachnoid hemorrhage were reported, in which aneurysms had been clipped and super-selective intra-arterial infusion of papaverine (IAP) and percutaneous transluminal angioplasty (PTA) were employed for the treatment of symptomatic cerebral vasospasm. Results Satisfactory clinical outcome was obtained in 4 patients in which endovascular therapies were used within 2 hours after the onset, whereas moderate deficits remained in 1 patient treated in 10 hours. Conclusion In patients with aneurysmal subarachnoid hemorrhage in whom conservative therapy including hypertensive, hypervolemic therapy and calcium channel blocker nimodipin has failed, PTA and IAP have become a valuable therapeutic alternative and can get a better effect if used as early as possible.