全脑血管造影术并发症的分析

Analysis of complications of cerebral panangiography

目的回顾性分析单纯全脑血管造影术围操作期的并发症。方法 2008年7月—2009年6月在首都医科大学宣武医院介入放射诊断治疗科单中心完成单纯全脑血管造影术2460例。其中男1608例,女852例,年龄为2～84岁,平均(60±3)岁。分析其术后并发症的发生情况。结果全脑血管造影术后共31例出现并发症,发生率为1.26%,其中局部并发症19例,发生率为0.78%,分别为皮下血肿9例,动脉夹层3例,血管开口狭窄2例,导管打折2例。神经系统并发症7例,发生率为0.29%,分别为血管痉挛3例,栓塞事件1例,其他(包括心慌、血压下降、恶心、呕吐等)3例。全身并发症共5例,发生率为0.20%,分别为对比剂过敏反应2例,对比剂肾病2例,鱼精蛋白过敏1例。经合理处理后,全脑血管造影术后并发症患者均未出现严重后遗症。结论在规范操作的基础上,单纯全脑血管造影术是安全的,并发症较低。同时随着造影设备的不断改进,术前术中准备充分,操作耐心细致,可进一步减少其并发症。

Objective To analyze the complications of cerebral panangiography retrospectively. Methods A total of 2460 patients whom underwent cerebral panangiography in the Department of Interventional Radiology, Xuanwu Hospital, Capital Medical University from July 1,2008 to June 30,2009 were analyzed. Among them,1608 were men,and 852 were women,the age ranged from 2 to 84 years （60. 3 - 2. 5 years）. Results A total of 31 patients （ 1.26% ） had complications of panangiography, of them, 19 patients（0. 78% ） had local complications, included subcutaneous hematoma （n = 9）, artery dissection （ n = 3 ）, narrowed vascular opening （ n = 2 ）, and fold of the catheter （ n = 2 ）. Seven patients （ 0. 29% ） had neurological complications, such as nerve reflex （ n = 3 ） , vasospasm （ n = 3 ） , and embolie events （ n = 1 ）. Five patients（0. 2% ） had systematic complications, such as allergic reaction to contrast agent （n =2）, contrast-induced nephropathy （ n = 2 ）, and protamine allergy （ n = 1 ）. After proper management, the patients did not have serious sequel following panangiography. Conclusion The simple cerebral panangiography is safe, and the incidence of complication is low. with the further improvement of equipment, adequate pre- and intraoperative preparation, and careful manipulation may further reduce the occurrence of complications.