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目的评价使用可脱卸弹簧圈(GDC、EDC、DCS)栓塞治疗颅内动脉瘤的临床效果,分析可脱卸弹簧圈栓塞治疗急性破裂出血动脉瘤过程中脑血管痉挛的发生及处理办法。方法血管内栓塞治疗Hunt-HessⅠ-Ⅲ级动脉瘤病人30例,6例患者同时加用腰穿放置腰椎蛛网膜下腔持续引流,观察栓塞效果及症状性血管痉挛的发生情况。结果本组病人共发生症状性血管痉挛4例,而6例腰穿置管患者无一发生血管痉挛。所有患者随访1~24个月,4例症状性脑血管痉挛病人中度致残2例,其余病人恢复良好。结论血管内栓塞是治疗颅内动脉瘤较理想的方法,具有微创、安全可靠、效果确切的特点。腰穿放置腰椎蛛网膜下腔持续引流可能对减少症状性脑血管痉挛的发生有积极意义。
Objective To evaluate the clinical effect of embolization with detachable coil (GDC, EDC, DCS) for the treatment of intracranial aneurysms and analyze the incidence and treatment of cerebral vasospasm during the treatment of acute ruptured aneurysm with removable coil embolization. Methods Thirty patients with Hunt-Hess Ⅰ-Ⅲ grade aneurysm were treated with endovascular embolization. Six patients underwent continuous lumbar puncture and lumbar subarachnoid drainage to observe the embolization effect and the occurrence of symptomatic vasospasm. Results The group of patients with symptomatic vasospasm occurred in 4 cases, while 6 cases of lumbar puncture catheter in patients without vasospasm. All patients were followed up for 1 ~ 24 months, 4 patients with symptomatic cerebral vasospasm were moderate disability in 2 cases, the rest of the patients recovered well. Conclusion Endovascular embolization is an ideal method for the treatment of intracranial aneurysms. It has the characteristics of minimally invasive, safe and reliable, with definite effect. Lumbar lumbar punctual placement of sustained subarachnoid drainage may have a positive effect on the reduction of symptomatic cerebrovascular spasm.