脑血管病的介入检查和治疗

Interventional Examination and Treatment of Cerebrovascular Disease

目的:探讨神经外科血管内介入方法在脑血管疾病诊断和治疗上的临床意义。方法:对71例有适应证者行选择性全脑血管造影术,对脑血管病作出明确病因诊断;对出血性脑血管病(包括3例脑AVM、40例脑动脉瘤)行血管内介入栓塞治疗;对于缺血性脑血管病,依据临床表现及造影结果,全面评估后行药物治疗或支架置入术。结果:40例脑动脉瘤31例获得治愈,7例留有不同程度后遗症,2例死亡;3例脑AVM畸形团近完全栓塞;11例颈动脉狭窄经血管内及药物治疗症状明显改善。结论:选择性全脑血管造影术成为脑血管疾病诊断的"金标准",血管内治疗已成为脑血管疾病的主要治疗方法之一,为其提供了微创、安全、有效的治疗新方法,并逐渐成为某些脑血管病(如脑动脉瘤、颈椎动脉狭窄)的首选治疗方法。随着治疗观念的改进、新型设备材料的研制和核心技术的普及,血管内治疗必将得到更广阔的发展。

Objective： To study the clinical significance of neurosurgery endovascular intervention to diagnosis and treat cerebrovascular disease. Methods： To diagnose 71cases with indication for etiology by selective global cerebral angiography; To treat hemorrhagic cerebrovascular disease（3 cerebral AVM, 40 cerebral aneurysm） by endovas cular embolization;To treat ischemic cerebrovascular disease by drug or stent endoprosthesis after thorough evaluation by clinical features and angiography result. Results： 31 cases were cured in 40 cerebral aneurysm, 7 with sequelae, 2 died; 3 cerebral AVM were completelyoccluded： 11 carotid stenosis were improved by intravascular treatment and drug. Conclusion： Selective global cerebral angiography hasbeen gold standard to diagnose cerebrovascular disease, and intravascular treatment hasbeen the one of main. Neurosurgery endovascular intervention provides the mini - invasive, safe, effective and new way, and hasbeen gradually the first - line therapy for some cerebrovascular diseases cerebral aneurysm, carotid stenosis）, it will get vaster development with the improved treating concept, new equipment and materials, key technique popularization.