栓塞技术在复杂颅内动脉瘤血管内治疗中的适应证和临床效果

Indications and Clinical Effects of Endovascular Treatment on Complicated Intracranial Aneurysms with Endovascular Embolization

目的:探讨栓塞技术在复杂颅内动脉瘤血管内治疗中的适应症和临床疗效。方法:复杂颅内动脉瘤患者40例,结合患者的具体病情,给予常规可脱弹簧圈技术、支架载瘤动脉成形术、球囊再塑形技术、载瘤动脉闭塞术、双微导管技术等进行治疗。于治疗前、后检测患者的血小板计数及活化部分凝血活酶时间(APTT),并判断疗效。术后随访6个月,判断患者预后。结果:治疗后完全栓塞22个,次完全栓塞12个,不完全栓塞6个;患者永久性致残2例,死亡1例;治疗前、后血小板计数及APTT差异无统计学意义(P>0.05)。术后6个月随访患者30例,康复23例(76.7%),显效4例(13.3%),好转2例(6.7%),死亡1例(3.3%)。结论:结合患者颅内动脉瘤的类型,采取不同类型的血管栓塞技术进行治疗,可达到较好的临床治疗效果。

Objective： To investigate the indications and clinical effect of endovascular embolization in the treatment of complex intracranial aneurysms. Methods： Forty cases with complicated intracranial aneurysms were enrolled. According to the specific condition,- cases were given routine detachable coil technology, support parent artery forming technique, the balloon and shaping technology, aneurysm occlusion operation, or double micro catheter technique. The number of blood platelets and therapy efficiency were analyzed before and after treatment. Results： After treatment, there were 22 cases with complete embolization, 12 with nearly complete, and 6 with incomplete embolization. The number of blood platelets showed no difference between before and after treatment （P〉0.05）. Thirty patients have been followed up for 6 months. In all, 23 cases were recovered, 4 cases partially effective, 2 cases improved, and 1 case died. Conclusion： Types of intracranial aneurysms are pivotal for the choice of,vascular embolization techniques.