微弹簧圈栓塞颅内动脉瘤73例分析

Embolization of intracranial aneurysms with micro-coils analysis of 73 cases

目的:总结使用微弹簧圈栓塞颅内动脉瘤的体会,探讨其手术适应症、方法、疗效及其并发症。方法:回顾性分析2003年6月～2008年6月对73例颅内动脉瘤患者进行微弹簧圈栓塞术,其中62例为破裂动脉瘤;按Hunt&Hess分级Ⅰ级8例,Ⅱ级26例,Ⅲ级29例,Ⅳ级8例,Ⅴ级2例。其中62例行急诊栓塞,手术在DSA动态监视下完成,术后常规腰椎蛛网膜下腔持续引流,并给以3H(高血压、高血容量、血液稀释)治疗。结果:动脉瘤完全闭塞57例,栓塞达90%12例,栓塞在90%以下4例,死亡2例。结论:微弹簧圈栓塞颅内动脉瘤具有安全、疗效可靠的优点,对破裂的动脉瘤行急诊栓塞治疗及术后蛛网膜下腔持续引流可明显提高疗效。

Objective：To preliminary summarize the experience on the intracranial aneurysms embolization with micro-coil, and investigation the surgical indications, evaluations, effects and its complications. Methods： Retrospective analysis of 73 patients from June 2003 to June 2008 with intracranial aneurysms embolized by using miaro coil, including 62 cases of ruptured intraeranial aneurysms; by Hunt ＆ Hess grade Ⅰ grade 8 cases, Ⅱ grade 26 cases, Ⅲ grade 29 cases, Ⅳ grade 8 cases, Ⅴ grade 2 cases. 62 emergency embolization routine surgery at DSA dynamic monitoring completed after continuous lumbar subarachnoid drainage, and to give 3H （Hypertension.Hypervolenia. Hemodilution）therapy. Results： Aneurysms 57 cases of total occlusion, embolization over 90 % in 12 cases, less than 90 % in 4 cases, 2 cases of death. Conclusion： The results suggested that embolization of intracranial aneurysms with microcoils be safe, effictive and reliable.The ruptured aneurysm need emergency embolization and postoperative treatment of continous lumbar subarachnoid drainage ,which can significantly improve efficacy.