头颅CTA成像在囊状颅内动脉瘤破裂风险评估中的应用价值

目的分析头颅CT血管造影术(CTA)成像在囊状颅内动脉瘤破裂风险评估中的应用价值。方法选择我院2012年1月~2015年12月收治的囊状动脉瘤患者200例作为研究对象,按照肿瘤破裂情况将患者分成两组,破裂组(n=97)和未破裂组(n=103),采用CTA技术对患者实施颅内检查,对瘤体长度、瘤颈宽度、瘤体深度与瘤颈宽度的比值(AR)值等指标进行检测,并观察子囊情况,对CTA检查结果与颅内动脉瘤破裂之间的相关性展开分析。结果破裂组患者瘤体长度、瘤颈宽度、AR值、瘤体深度与载瘤动脉直径的比值(SR值)以及动脉瘤倾斜角显著高于未破裂组(P<0.05),破裂组有44例患有子囊,发生率为45.36%,未破裂组有14例患有子囊,发生率为13.59%。破裂组子囊发生率高于对照组(P<0.05)。结论颅内动脉瘤破裂与瘤体长度、瘤颈宽度、AR值、SR值、动脉瘤倾斜角以及子囊情况有关,瘤体越长、瘤颈越宽、发生子囊等均会增加破裂风险,临床应对其给予足够的重视。

Treatment for severe craniocerebral trauma combined with transtentorial hernia in children

Objective: To explore the treating method for severe craniocerebral trauma combined with transtentorial hernia in children.Methods: We treated 58 children with severe craniocerebral trauma combined with transtentorial hernia through evacuating the hematomas, incising the tentorium but preserving the floating bone flap between January 1996 and January 2002.Results: GCS was 3-5 in 17 cases and 6-8 in 41 cases. After treatment, 46 patients ((79.30)%) recovered well, 6 ((10.30)%) suffered from mild disability, 1 ((1.72)%) suffered from severe disability, 1 ((1.72)%) was in vegetative state, and 4 ((6.90)%) died.Conclusions: Evacuating hematomas and incising tentorium can effectively treat the child patients with severe craniocerebral trauma combined with transtentorial hernia, which can decrease the disability and mortality rates greatly, preserve the skull, exempt reoperation for cranioplasty and relieve the psychologic and physiologic burden of the child patients.