动脉硬化型颅内动脉瘤的综合治疗

Comprehensive treatment of arteriosclerotic intracranial aneurysms

目的 总结和探讨动脉硬化性动脉瘤的综合治疗方法。方法 对16例动脉硬化型动脉瘤病人进行了综合治疗,用GDC进行血管内动脉瘤栓塞治疗其病因;腰穿置管稳压引流缓解症状,防止出现急性脑积水;通窍活血汤防止迟发性缺血性脑损害。结果 在保持载瘤动脉通畅的情况下,15例动脉瘤完全栓塞,1例98％栓塞,病人头痛时间明显缩短,所有患者无再出血、脑血管痉挛或迟发性缺血性脑损害等并发症发生。结论 对硬化型动脉瘤应采取综合性治疗能明显提高疗效、缩短病程、降低致残率。

Objective To explore and summarize the comprehensive treatment of arteriosclerotic intracranial aneurysms. Methods 16 patients of arteriosclerotic intracranial aneurysm were treated with endovascular embolization therapy with Guglielmi detachable coils (GDC), lumbar drainage under the steady pressure avoiding acute hydrocephalus, and Tongqiaohuoxue decoction against delayed ischemic brain injury. Results With the parent artery unblocked, 15 cases were treated with complete embolization, and 1 case with 98% embolization. Headache time was shortened significantly. No rebleeding, cerebral vasospasm or delayed ischemic brain injury were observed. Conclusion Comprehensive management, beneficial to desirable prognosis, short course and low disability rate, should be taken for arteriosclerotic intracranial aneurysms.