摘要
目的 探讨电解脱微弹簧圈 (GDC)颅内动脉瘤血管内栓塞后缺血的临床治疗以及相关影响因素和预防措施。方法 本组 6例 ,均为动脉瘤破裂致蛛网膜下腔出血 ,行致密栓塞。结果 GDC栓塞后出现载瘤动脉主干或分支狭窄或闭塞。 6例术中闭塞缺血 3例 ,栓塞后 2 4h出现 3例。经术中溶栓、解痉和术后三高、抗痉挛及腰穿等综合治疗后 ,4例恢复良好 ,2例遗留偏瘫 ,6例患者至今存活。结论 载瘤动脉主干狭窄或闭塞是GDC治疗的常见并发症 ,术中动态观察载瘤动脉血供 ,了解栓塞程度是预防其发生的手段之一 ;出现狭窄或闭塞时 ,及时调整微导管和GDC ,并给以抗痉挛、抗凝、扩血管以及三高治疗 ,当出现恶性颅高压症时手术配合治疗 ,往往会取得较好的临床效果。
Objective To discuss treatment and prophylactic for cerebral arterial ischemia of intracranial aneurysms after embolazation with GDCs. Methods Six cases with subaranoid hemorrhage spontaneous (SAH), including 4 males and 2 females, occurred cerebral ischemia appearances in original artery or its branchs with GDCs treatment. Results Fully GDC-embolization were undertaken in six patients. Cerebral arterial ischmia occurred in 3 cases during embolized procedure and 3 cases 24hrs after embolized treatment. Cerebral ischmia occurred at A2 of ACA in one case, at perforating branches in two cases, MCA in two cases, and BSA in one case. The clinical symptoms of cerebral ischmia were as following: headache, dizzy, hemiplegia, logagnosia, hemianopia and haemorrhagia. Conservative treatment were undertaken as 3H management, combining with antispasm, anticoagulatlon and lumbar puncture treatment. Among the six patients, four cases got fully released, 2 cases had hemiplegiah, but finally recovered within 3 weeks.Conclusion Cerebral ischemia is a common complication of GDC dealing. The blood supply and embolized degree of original artery should be carefully evaluated during GDC embolization procedures. In case of emphraxis or stenosis occurred, microcatheter and GDC should be adopted at once., and conservative treatment combining with antispasm, anticoagulatlon and lumbar puncture treatment would be helpful. [
出处
《中国医学影像技术》
CSCD
2003年第9期1152-1154,共3页
Chinese Journal of Medical Imaging Technology
关键词
颅内动脉瘤
缺血
治疗
Intracranial aneurysm
Ischemia
Treatment
