颅内动脉瘤破裂的介入治疗时机及继发脑血管痉挛的防治

Interventional therapy of intracranial aneurysm rupture and prevention and treatment of cerebral vasospasm.

目的探讨颅内动脉瘤破裂介入治疗的时机及脑血管痉挛(CVS)的防治方法。方法采用早期介入栓塞治疗,术中动脉灌注、术后静脉滴注罂粟碱,应用白蛋白、低分子右旋糖酐、小剂量多巴胺以及腰椎穿刺放血性脑脊液等综合措施。结果CVS的发病率为24.4%。预后良好72.1%,病死率1.2%。结论早期介入治疗有利于预防颅内动脉瘤再次破裂,综合运用上述措施能较好地防治继发CVS,改善预后。

Objective To explore the interventional therapy of intraeranial aneurysm rupture and the prevention and treatment of cerebral vasospasm （ CVS）. Methods Comprehensive measures （including interventional embolism, artery perfusion, intra-arterial papaverine dripping, albumin ,low molecular dextran, small dose of dopamine and lumbar puncture for releasing hemorrhagic eerebrospinal fluid） were performed. Results The incidence rate of CVS was 24.4%. The prognosis was good in 72.1% eases and the mortality rate was 1.2%. Conclusion The early interventional therapy will be beneficial for the prevention and treatment of intraeranial aneurysm rupture for the second time. The comprehensive measures may effectively prevent and treat the secondary cerebral vasospasm and improve the prognosis.