破裂后颅内动脉瘤介入手术相关并发症分析与防治对策

doi:10.3760/cma.j.issn.1671-8925.2008.04.022

科研成果详情

题名	破裂后颅内动脉瘤介入手术相关并发症分析与防治对策
其他题名	Analysis of complications and strategies of prevention and treatment in endovascular embolotherapy of ruptured intracranial aneurysm
作者	虞希祥; 张顺开; 司同国; 南忆; 易兴阳; 吴安生; 施振静; 朱国庆
发表日期	2008-04-15
发表期刊	中华神经医学杂志影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	颅内动脉瘤血管内栓塞并发症对策
其他关键词	Intracranial aneurysms ; Indovascular embolotherapy ; Complications ; Countermeasures
摘要	目的分析破裂后颅内动脉瘤血管内栓塞手术相关并发症的发生原因及防治方法。方法68例破裂后颅内动脉瘤采用早期血管内栓塞治疗,术中对动脉痉挛采用经微导管灌注罂粟碱或球囊扩张解痉;对弹簧圈堵塞载瘤动脉采用抗凝或抗血小板治疗;对动脉瘤破裂采用中和肝素继续栓塞;对动脉血栓形成采用栓塞后经微导管灌注r-tPA溶栓。结果68例中出现并发症8例,占11.77%。其中大脑中动脉广泛性痉挛1例,出现脑梗死,轻度偏瘫;局限性痉挛2例,治疗后无后遗症;弹簧圈部分进入大脑中动脉1例,治疗后无脑梗死;弹簧圈脱落脑梗死1例,术中动脉瘤破裂1例,继续栓塞无不良后果;术后1周动脉瘤再次破裂死亡1例;血栓形成大面积脑梗死偏瘫1例。结论清楚显示动脉瘤的部位、形态、大小以及与载瘤动脉的关系有助于栓塞的成功;合理选择弹簧圈规格及熟练掌握操作技术能降低并发症的发生率;术中及时妥当处理并发症可明显改善预后情况。
其他摘要	Objective To analyze the cause, prevention and treatment of complications related to endovascular embolotherapy for ruptured intracranial aneurysms. Methods Sixty-eight patients with ruptured intracranial aneurysms received early endovascular embolization. Intraoperatively, artery spasm was relieved by papaverine infusion through microcatheter or balloon dilatation; parent artery occlusion by coils was treated by anticoagulation or antiplatelet treatment; ruptured aneurysms were embolized using mixed heparin; arterial thrombosis after embolization was ameliorated by the micro-catheter infusion of r-tPA thrombolytic. Results In the 68 cases, 8 cases suffered from complications, accounting for 11.77%. Among them, 1 case of extensive spasm of middle cerebral artery developed cerebral infarction and mild hemiplegia; 2 cases of localized spasm were improved well without sequelae; 1 case in which partial coils entered middle cerebral artery achieved a satisfied therapeutic outcome without infarction; 1 case with cerebral infarction due to coil dropping and 1 case with aneurysm rupture during operation received secondary embolotherapy without adverse consequences; one week after operation, 1 case died from aneurysm re-rupture; 1 case had hemiplegia owing to massive cerebral infarction. Conclusions It will do much benefit to secure the success of the operation by displaying the location, shape and size of the aneurysms as well as the relationship with the parent artery. Moreover, the proper choice of coils and well mastering of operative skills can decrease the incidence of complications, and adequate and prompt treatment of intraoperative complications can improve the prognosis of the patients obviously.
ISSN	1671-8925
卷号	7 期号:04 页码:406-409
DOI	10.3760/cma.j.issn.1671-8925.2008.04.022
页数	0
收录类别	CNKI ; 万方 ; 北大核心 ; PKU ; ISTIC
URL	查看原文
万方分类号	R743(神经病学与精神病学)
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/80158
专题	其他_附属第三医院（瑞安市人民医院）
作者单位	温州医学院附属第三医院(瑞安医院)介入科
第一作者单位	其他_附属第三医院（瑞安市人民医院）
第一作者的第一单位	其他_附属第三医院（瑞安市人民医院）
推荐引用方式 GB/T 7714	虞希祥,张顺开,司同国,等. 破裂后颅内动脉瘤介入手术相关并发症分析与防治对策[J]. 中华神经医学杂志,2008,7(04):406-409.
APA	虞希祥., 张顺开., 司同国., 南忆., 易兴阳., ... & 朱国庆. (2008). 破裂后颅内动脉瘤介入手术相关并发症分析与防治对策. 中华神经医学杂志, 7(04), 406-409.
MLA	虞希祥,et al."破裂后颅内动脉瘤介入手术相关并发症分析与防治对策".中华神经医学杂志 7.04(2008):406-409.