电解脱性弹簧圈栓塞颅内动脉瘤围手术期治疗36例疗效观察

Perioperative treatment of intracranial aneurysm with Guglielmi detachable coil embolization

目的探讨电解脱性弹簧圈（GDC）栓塞颅内动脉瘤的围手术期治疗。方法回顾性分析36例颅内动脉瘤患者GDC栓塞的围手术期治疗过程以及治疗效果。结果100％栓塞11例。95％栓塞硬膜下血肿、脑疝，行去骨瓣减压血肿清除术后好转；术后2例并发脑积水，行脑室-腹腔分流术后恢复。术后3个月随访，32例日常生活能力（activity daily living，ADL）达Ⅰ～Ⅲ级。结论术前防治再出血和脑血管痉挛、术后防治并发症等正确的围手术期治疗，能明显改善患者的预后。

Objective To analyze perioperative treatment of intracranial aneurysm with Guglielmi detachable coil embolization, Methods The perioperative treatment and clinical outcomes of 36 patients with intracranial aneurysm who underwent Guglielmi detachable coil embolization were reviewed. Results Complete embolizations were achieved in ,11 patients, 95% embolizations in 18 patients, and 90% embolizations in 7 patients. Two patients died postoperatively. One patient developed postoperative subacute subdural hematoma and resultant hernia, but ameliorated after removal of the hematom and decompression by removing bone flap, Postoperative hydrocephalus developed in 2 patients, who recovered following ventriculo-peritoneal shunts. Follow-up after 3 months of operation showed that 32 patients had an activity daily living （ADL） score of Ⅰ - Ⅲ. Conclusion Preoperative prevention and treatment of rehemorrhage and cerebral vasospasm and postoperative prevention and treatment Of complications will significantly improve the prognosis of the patients.