自发性蛛网膜下腔出血的DSA分析及治疗

The Study of DSA Imaging and Treatment in Spontaneous Subarachnoid Hemorrhage

目的通过分析自发性蛛网膜下腔出血的全脑血管造影及其治疗,探讨蛛网膜下腔出血全脑血管造影的表现、造影时间的选择及治疗方法的选择。方法回顾分析1998～2003年收治的28例蛛网膜下腔出血的全脑血管造影及其治疗方法的临床资料。结果 28例全脑血管造影共发现19个动脉瘤;造影时间选择在3d内及2周后的患者共23例,在3 d～2周内进行造影的有5例,动脉瘤的GDC栓塞治疗3例,手术动脉瘤颈夹闭治疗5例,动脉瘤包裹治疗6例。结论全脑血管造影可以清晰显示瘤体、瘤颈的形态及与载瘤血管的关系;对蛛网膜下腔出血在3d内及2周后的患者进行全脑血管造影可以提高动脉瘤的检出率;动脉瘤的GDC栓塞治疗相对于外科手术并发症少、恢复快,是动脉瘤治疗的发展方向。

Objective Through analyzing encephalon angiography and therapeutic method of spontaneous subarachnoid hemorrhage, to explore the manifestation of encephalon angiography and the optimal time of angiography and the choice of therapeutic method with spontaneous subarachnoid hemorrhage. Methods Retrospective analysis was made on the clinical data of 28 patients with spontaneous subarachnoid heorrhage admitted to our hospital from 1998 to 2003. Results Out of the 28 cases of encephalon angiography, there were 19 aneurysms. The angiography of 23 cases were made in 3 days or after 2 weeks. The angiography of 5 cases were made between 3rd day and the end of 2nd week. 3 cases were treated with GDC technique of coil embolization of aneurysms;aneurysms's neck in five cases were clamped by surgery;6 cases were enwrapped by surgery. Conclusion The body, neck and parent vessel of aneurysms can be clearly displayed by encephalon angiography;encephalon angiography with subarachnoid hemorrhage within 3 days or after 2 week can improve the probability in finding out aneurysms. The GDC technique of coil embolization of aneurysms has less complications and the recovery is sooner than those treated by surgery, and this is the tendency of the treatment of aneurysms.