出血性脑动脉瘤介入栓塞术后脑血管痉挛的临床研究

The clinical study of cerebral vasospasm after ruptured aneurysms treated by interventional embolization

目的：研究出血性脑动脉瘤介入栓塞手术后脑血管痉挛（CVS）的治疗和预后。方法：分析aSAH患者152例，Hunter-hess分级在I～Ⅳ级，发病5d内进行介入栓塞手术治疗。术后通过TCD检测CVS严重程度。结果：发生CVS69例，其中术前发生21例，术中发生13例，术后发生35例，CVS患者经处理后大部分缓解，但仍有6例发生脑梗塞，1例因大面积小脑梗死而死亡。结论：aSAH并发CVS仍是常见并发症，应重视aSAH合并脑血管痉挛的早期预测和治疗，才能彻底改善脑血管痉挛（CVS）患者预后，提高治疗效果。

Aim： To analysis the treatment and prognosis of cerebral vasospasm （CVS） after ruptured aneurysms treated by interventional embolization. Methods： 152 aSAH patients were in I- IV level of Hunter-Hess classification, and were received the interventional embolization surgery within 5 days. Testing severity of CVS by TCD after surgery. Results： 69 cases of CVS occurred in 152 patients（21 cases occurred preoperative, 13 cases occurred intraoperative, 35 cases occurred postoperation） . The most of CVS patients＇ symptoms were relief after treatment, But 6 cases were occured cerebral infarction, 1 case was died from the large area of cerebellar infarction. Conclusion：CVS is still the common complications after rupture of aneurysm. We should pay attention to the early prediction and new methods of treatment of aSAH complicate with CVS, then improving curative effect of patients with cerebral vasospasm （cvs）.