60例脑血管疾病患者脑血管造影诊断及介入治疗分析

The Analysis of DSA Diagnosis and Neuro-interventional Therapic Results in 60 Patients with Cerebrovascular Diseases

目的分析总结既往脑血管疾病患者的脑血管造影（DSA）诊断及介入治疗情况，对今后脑血管病介入诊治的开展提出建议。方法结合文献综述，对本院神经内科介入治疗的启动与发展进行回顾性分析，并对既往脑血管疾病患者的DSA诊断及治疗情况进行分析总结。结果2007年11月～2010年10月共纳入符合条件的脑血管疾病患者60例，其中男性33例，女性27例，平均年龄46±11岁。其中出血性及出血前脑血管疾病29例（48．3％），缺血性脑血管疾病患者22例（36．7％），其他脑血管疾病9例（15．0％）。实施动脉瘤介入栓堵治疗11例；颈动脉狭窄支架置入术2例；锁骨下动脉支架置入术1例；锥动脉开口部支架置入术1例；颅内静脉窦血栓碎栓及球囊扩张术2例；海绵窦动静脉瘘介入栓堵术2例。介入治疗成功率100％，发生轻度并发症2例（2．9％），无严重并发症及死亡病例。结论只要严格掌握适应证，选择合适的病例、材料和方法，并进行充分的术前血流动力学评价，结合谨慎而熟练的操作，配合妥善术后观察和处理，登记和随访研究等措施的实施，神经介入必将会作为安全有效的脑血管病诊治手段为脑血管病的诊治带来质的飞跃。

Objective To put forward suggestions on how to establish endovascular management unit for cerebrovascular disease throngh summarizing previous cases treated with cerebral angiography diagnosis and intervention. Methods After literature being reviewing, medical notes of the cerebrovascular disease patients treated with angiography diagnosis and interventional therapy in Department of Neurology of the hospital were analyzed. Results From November 2007 to October 2010,60 eligible patients were recruited,including 33 male and 27 female. The average age was 46 ± 11 years. 48.3% of these subjedts （29 cases） suffered from hemorrhagic cerebrovascular disease and 22 cases （ 36.7% ） were ischemic cerebrovascular disease patients ,9 （ 15.0% ） were cases with other cerebrovascular disease were. 11 intervention for cerebrovascular aneurysm,2 carotid stenting, 1 subclavian artery stenting,2 intracranial venous sinus thrombosis thrombectomy and balloon dilatation and 2 cavernous sinus fistula intervention had been carried out, among which the success rate was 100% , with no serious complication or death. Conclusion Based on clear indications,appropriate materials and methods,adequate preoperative hemodynamic evaluation and sophisticated skill, as well as proper postoperative measures and follow - up after discharge, endovascular management would improve cerebrovascular disease treatment substantially.