介入性血管栓塞术治疗Ⅳ、Ⅴ级颅内动脉瘤破裂出血的疗效回顾性研究

Retrospective study on the curative effect of interventional vascular embolization operation in the treatment of Ⅳ and Ⅴ grade ruptured intracranial aneurysm

目的:探讨介入性血管栓塞术治疗Ⅳ、Ⅴ级颅内动脉瘤破裂出血的疗效。方法:收治颅内动脉瘤破裂出血患者37例,Ⅳ级28例,Ⅴ级9例,给予介入性血管栓塞术治疗,分析近期疗效、并发症及随访结果。结果:37例共41个动脉瘤,脉瘤腔100%闭塞34个(82.93%),95%闭塞4个(9.76%),90%闭塞3个(7.32%)。按哥斯拉预后评分(GOS):5级17例(45.95%),4级12例(32.43%),3级9例(24.32%),2级2例(5.41%),死亡1例(2.70%)。随访无复发病例。栓塞并发症5例(6.94%),蛛网膜下腔出血并发症13例(35.14%),其他全身并发症11例(27.93%)。结论:在控制适应证与禁忌证的前提下,Ⅳ、Ⅴ级颅内动脉瘤破裂出血患者仍可采取介入性血管栓塞术治疗;术中、术后积极预防蛛网膜下腔出血及脑血管痉挛等并发症,可获得较好的结果。

Objective:To explore the curative effect of interventional vascular embolization operation in the treatment of Ⅳ and Ⅴgrade ruptured intracranial aneurysm.Methods:37 patients with ruptured intracranial aneurysm were selected,Ⅳ grade in 28 cases,Ⅴ grade in 9 cases.They were given interventional vascular embolization operation treatment.The recent curative effect,complications and follow-up result were analyzed.Results:37 cases had 41 aneurysms;34(82.93%) were 100% occlusion of veintumor cavity;4(9.76% ) were 95% occlusion;3(7.32% ) were 90% occlusion.According to the Godzilla prognosis score(GOS),17cases(45.95% ) were 5 grade;12 cases(32.43% ) were 4 grade;9 cases(24.32% ) were 3 grade;2 cases(5.41% ) were 2 grade;1case(2.70% ) were died.No recurrence cases were followed up.5 cases(6.94% ) had embolization complication;13 cases(35.14% )had subarachnoid hemorrhage complication;11 cases(27.93% ) had other systemic complication.Conclusion:In the premise ofcontroling indications and contraindications,the patients with Ⅳ and Ⅴ grade ruptured intracranial aneurysm can takeinterventional vascular embolization operation treatment.The intraoperative and postoperative prevention of subarachnoidhemorrhage,cerebral vasospasm and other complications can obtain good results.