颅内动脉瘤介入治疗21例

目的总结电解可脱卸弹簧圈（GDC）栓塞治疗颅内动脉瘤的临床经验。方法 21例颅内动脉瘤（23个）患者中17例为破裂动脉瘤。接Hunt-Hess分级I级2例,Ⅱ级1例,Ⅲ级6倒,Ⅳ级10倒,V级2例。16例行急诊栓塞,术后腰椎蛛网膜下腔持续引流,并予以3h治疗。结果动脉瘤完全闭塞20个,闭塞达90%以上2个。闭塞在90%以下1个。全组手术死亡1例。随访1～30个月。1例术后2周死于中枢衰竭及肺部感染;1例术后1.5月复发出血,经手术夹闭痊愈;1例有轻度神经功能缺失症状,其余恢复良好。结论 GDC栓塞颅内动脉瘤安全、可靠,以致密填塞动脉瘤疗效为佳,破裂动脉瘤急诊栓塞治疗。术后腰椎蛛网膜下腔持续引流可明显提高疗效。

21 cases of intracranial aneurysms interventional therapy

Objective To retrospectively study treatment by Guglielmi detachable coil（ GDCs） of intracranial aneurysm. Methods 21 case patients with intracranial aneuryams（ 23entries） including 17 case ruptured aneurysms,Hunt-Hess grade： I 2cases. Ⅱ1cases. Ⅲ6cases,Ⅳ10 cases. V 2 case. 16 cases patients were treated with emergency. Continuous lumbar subarachnoid drainage was instituted and standard three-h treatment was given poatopertively. Results Total occlusion was achieved in 20 aneurysms,over 90 in 2 aneurysms. 1ess than 90 in 1 aneurysms. with 1 patients diedinthe cohort. One case rebleeded after one and a halfmonths andwas cured by surgical clipping,1 patients experienced enlargement of the aneurysmal neck and were reembolized. Conclusion Embolization of intraeranial aneurysms with GDCs is safe. effective and reliable. Partial packing may result in continuous enlargement. rupture and bleeding,white tight coil packing is reli-able. The ruptured aneurysms need emergent embolization and con ～ nuous lumbar subarachnoid drainage postoperatively canenhance curative effect significantly.