双C臂造影机在拟诊为动脉瘤破裂出血患者诊断和治疗中的应用

Application of double C-arm angiography machine in diagnosis and treatment of patients with aneurysmal rupture and hemorrhage

目的:探讨双C臂造影机在拟诊为动脉瘤破裂出血患者中诊断和治疗的应用。方法:回顾性分析我院神经科收治的32例拟诊为动脉瘤破裂出血患者的脑血管造影及介入治疗临床资料,并复习相关文献。结果:32例拟诊为动脉瘤破裂的患者中,男9人,女23人,平均年龄54.75±9.97岁,动脉瘤检出率为93.75%,均行3D重建造影,共发现35个动脉瘤,累及前交通动脉、大脑前动脉、颈内动脉、后交通动脉、椎基底动脉、小脑上动脉和小脑后下动脉。行Dyna-CT排除中线移位和动脉瘤二次破裂出血后,均在全麻下行弹簧圈填塞术,术后3～6月复查有2例复发,予弹簧圈再次补充填塞。造影未发现动脉瘤的患者起病1月后复查时未发现动脉瘤。结论:双C臂造影机对于动脉瘤的诊出率高且准确性强,可以帮助手术医生精确填塞动脉瘤,且对于动脉瘤复发具有极高的诊断价值。

Objective To explore the application of double C-arm angiography machine in diagnosis and treatment of patients with aneurysmal rupture and hemorrhage.Methods The clinical data of cerebral angiography and interventional therapy in 32 patients with aneurysm rupture and bleeding were analyzed retrospectively,and the related literature was reviewed.Results In 32 cases,9 men and 23 women were diagnosed as aneurysm rupture.The average age was 54.75±9.97 years old and the detection rate of aneurysm was 93.75%.All the aneurysms were detected by 3 D angiography,and totally 35 aneurysms were found,including anterior communicating arteryanterior cerebral artery,internal carotid artery,posterior communicating artery,vertebral basilar artery,superior cerebellar artery and posterior inferior cerebellar arteryAfter exclusion of midline displacement by DynaCT and second rupture of aneurysms,the coils were filled in the aneurysm under general anesthesia.3~6 months after the operation,2 cases had relapse,and new coil was filled in aneurysm again as a rescued therapy.Two patients whose aneurysm was not found at first were underwent angiography again and were found with no aneurysm after one month.Conclusion The double C-arm angiography machine is superior in diagnosing and treating aneurysm.The rate of diagnosis is high and the accuracy is strong.It can help surgeons accurately treat aneurysms and has high diagnostic value for the recurrence of aneurysms.