电解可脱性铂金弹簧圈早期栓塞治疗颅内破裂动脉瘤

Embolization of Intracranial Ruptured Aneurysms in Early Stage with GDC

目的探讨颅内破裂动脉瘤早期采用电解可脱性弹簧圈（GDC）栓塞治疗的效果。方法58例自发性蛛网膜下腔出血（SAH）经全脑数字减影血管造影（DSA）证实的颅内动脉瘤患者，分为GDC治疗组（30例）及对照组（28例）。对照组给予常规内科治疗；治疗组在DSA监视下，经股动脉，采用GDC栓塞治疗。观察两组病例的死亡率及治疗期间的并发症。结果治疗组术后死亡2例，术后随访1—2年，无再发动脉瘤破裂出血病例，病死率6．7％；对照组病程中死亡5例，随访1—2年再发动脉瘤破裂出血死亡4例，病死率32．1％，两组比较差异显著（P〈0．01）。结论GDC早期栓塞能显著降低颅内破裂动脉瘤的病死率。

Objective To discuss the effects of embolizing intracranial ruptured aneurysm with Guglielmi detachable coil （GDC） in early stage.Methods 58 cases of intracranial aneurysm,confirmed by DSA（digital subtraction angiography）were divided into GDC treatment group（30 cases） and control group（28 cases）. Under the observation of DSA, GDC treatment group was treated with GDC emboliation sac via femoral artery approach, while the control group was given medicine therapy. The mortality of the two groups and the complication were observed in the course of treatment. Results In GDC treatment group,2 patients died（6.7 % ）. Followed-up 1 - 2 years, none of them died from ruptured aneurysm. In the control group,5 cases died in the course of treatment. Followed-up 1 - 2 years, 4 cases died from ruptured aneurysm The mortality（32.1% ） of control group was obviously different from GDC treatment group（ P 〈 0.01 ）. Conclusion GDC embolization in earlier period can significantly reduce the mortality of intracranial ruptured aneurysm.