摘要
目的分析电解可脱卸弹簧圈(GDC)栓塞治疗急性破裂出血动脉瘤脑血管痉挛的发生及治疗。方法Hunt-HessⅠ～Ⅲ级并在发病后72h内进行GDC栓塞治疗的动脉瘤病人86例,症状性血管痉挛的诊断根据迟发性神经功能损害,并有TCD和/或脑血管造影的证据。结果共发生症状性血管痉挛17例(19.8%),血管痉挛的发生率和Hunt-Hess分级及Fisher分级有显著的相关关系,平均随访13个月,17例发生症状性脑血管痉挛病人中恢复良好12例,中度致残4例,重度致残1例。结论GDC栓塞治疗动脉瘤后症状性血管痉挛的发生率并不高于常规手术治疗;放置腰椎蛛网膜下腔持续引流可能对降低症状性脑血管痉挛的发生有积极意义。
Objective We analyzed the incidence and treatment of symptomatic vasospasm after early endovascular therapy of ruptured aneurysms with Guglielmi detachable coils.Method86patients classified as Hunt -Hess gradesⅠtoⅢwere treated with GDCs within72hours after aneurysm rupture.Symptomatic vasospasm was diagnosed as the onset of delayed neurological deterioration with evidence of angiographic or transcranial Doppler studies.Result Symptomatic vasospasm oc-curred in17patients(19.8%).Both Hunt-Hess grade and Fisher's scale before treatment correlated with the incidence of cerebral vasospasm.At a mean follow-up of13months,12patients recovered well,4were moderately disabled,and1was severely disabled.Conclusion The incidence of symptomatic vasospasm was relatively low comparing with conventional surgery.Continuous lumber puncture cerebral spinal fluid drainage may play an important role in reducing the incidence of cerebral vasospasm.
出处
《中国微侵袭神经外科杂志》
CAS
2002年第1期16-19,共4页
Chinese Journal of Minimally Invasive Neurosurgery
基金
国家自然科学基金资助项目(No.30100194)
