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目的分析颅内动脉瘤弹簧圈栓塞治疗术中出血的原因和防治对策。方法回顾性分析2003年3月-2012年8月358例颅内动脉瘤采用弹簧圈栓塞治疗患者,7例弹簧圈栓塞过程中出血,并继续栓塞止血。2例为弹簧圈栓塞中造影仅见血流明显变慢,术后CT证实的出血。术后对症治疗6例,开颅引流减压3例。结果 9例术中破裂者中8例致密栓塞,1例部分栓塞。5例恢复好,1例一过性动眼神经麻痹,3例死于颅内高压结论术中出血与手中操作、动脉瘤形态和患者血管条件、血压变化有关,继续填塞及合理术中与后续治疗可以挽救大部分患者生命。
Objective To analyze the cause of intraoperative bleeding in the treatment of intracranial aneurysm coil embolization and its prevention and treatment. Methods From March 2003 to August 2012, 358 patients with intracranial aneurysms were treated with coil embolization. Seven patients underwent coil embolization. Bleeding was continued and embolization was stopped. 2 cases of coil embolism angiography showed only significantly slower blood flow, postoperative CT confirmed bleeding. Postoperative symptomatic treatment in 6 cases, craniotomy drainage decompression in 3 cases. Results Among the 9 patients who underwent operation, 8 were densely embolized and 1 was partially embolized. 5 cases of recovery, 1 case of transient oculomotor nerve paralysis, 3 cases died of intracranial hypertension Conclusion Intraoperative bleeding in the hands of the operation, the morphology of aneurysms and vascular conditions in patients with blood pressure changes, continue to fill and reasonable intraoperative and follow-up Treatment can save the lives of most patients.