颅内动脉瘤破裂超早期血管内栓塞治疗的临床研究

Clinic study on embolization treat intracranial aneurysms in super-early stage.

目的 探讨颅内动脉瘤破裂超早期血管内栓塞治疗的临床意义。方法 通过对 13例 ( 15个 )以自发性蛛网膜下腔出血急诊入院 ,确诊为颅内动脉瘤破裂病例采用GDC超早期血管内栓塞治疗 ,9例于 1天内、4例于 2天内治疗。动脉瘤位置 :前交通动脉 7例 ( 1例为 2个 ) ,后交通动脉 3例 ,大脑前动脉 1例 ,大脑中动脉 1例 ,前交通动脉和后交通动脉多发 ( 2个 ) 1例 ;按HESS -HUNT分级 :Ⅰ级 2例 ,Ⅱ级 7例 ,Ⅲ级 3例 ,Ⅳ级 1例 ;首次破裂 10例 ,2次破裂 3例。结果 随访 3月～ 1年 ,13例 15个动脉瘤 ,恢复良好 11例 ,中等 1例 ,差 1例 ,无发生再出血病例。

Objective To explore the clinic significance of embolizing intracranial aneurysms in super-early stage.Methods Embolization of 13 cases(15 aneurysms)intracranial ruptured aneurysms including 10 cases of the first ruptured and 3 cases of second ruptured were performed in super-early stage using GDC,9 cases in 1day,and 4 cases in 2 days after ruptured.The locations of aneurysms were as following:7 cases in anterior communicating artery(1 case with 2 aneurysms),3 cases in posterior communicating artery,1 cases in anterior cerebral artery,1 cases in middle cerebral artery,and 1 case of multianeurysm in anterior and posterior communicating artery.HESS-HUNT grade was as following:2 cases of grade Ⅰ,7 cases of grade Ⅱ,3 cases of grade Ⅲ,1 case of grade Ⅳ.Results Follow-up from 3 months to 1 year after operation among 15 aneurysms in 13 cases,11 cases effects were well,1 case was medium,1 case was poor.Conclusion GDC embolization is a effective treatment for intracranial ruptured aneurysms in super-early stage.