颅内动脉瘤破裂栓塞治疗后症状性脑血管痉挛的发生及影响因素分析

目的探讨破裂颅内动脉瘤经血管内栓塞治疗后症状性脑血管痉挛的发生及相关因素。 方法河南大学附属南石医院神经外科自2008年5月至2010年1月应用电解可脱性弹簧圈栓塞治疗破裂动脉瘤78例，回顾性分析患者的临床资料，判定症状性脑血管痉挛的发生并分析其影响因素。 结果本组78例患者栓塞治疗均成功，术后出现症状性脑血管痉挛20例(25.6％)，不同Hunt-Hess分级、Fisher分级患者术后症状性脑血管痉挛的发生率差异有统计学意义(P＜0.05)。经积极治疗后14例恢复正常,3例中度致残，3例放弃治疗。 结论栓塞治疗破裂动脉瘤后症状性血管痉挛的发生与神经功能损害和出血量大小有关，腰大池引流对降低血管痉挛发生有积极意义。

Incidence of symptomatic cerebral vasospasm in patients with ruptured intracranial aneurysms after embolization and its risk factors

Objective To investigate the incidence of symptomatic cerebral vasospasm in patients with ruptured intracranial aneurysms after embolization and its correlative factors. Methods The clinical data of 78 patients with ruptured intracranial aneurysms after embolization, admitted to our hospital from May 2008 to January 2010, were retrospectively analyzed. The occurrence of symptomatic cerebral vasospasm was assessed and its influencing factors were analyzed. Results The embolization of these 78 patients was successful. Postoperative symptomatic cerebral vasospasm occurred in 20patients (25.6％). Significant differences in the incidence of cerebral vasospasm among patients of different Hunt-Hess grades, Fisher grades were noted (P＜0.05). Fourteen patients were back to normal and 3 had moderate disability after proper treatment,while the other 3 gave up treatment. Conclusion The occurrence of symptomatic cerebral vasospasm of patients with ruptured aneurysm atter embolization may be associated with the neurological damage degree and amount of bleeding. Lumbar drainage can positively reduce the incidence of cerebral vasospasm.