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为探讨颈内动脉—海绵窦瘘的形成原因及采用血管内栓塞治疗的疗效及并发症的预防措施。对 19例颈内动脉—海绵窦瘘的病人 ,分析其临床表现及CT、MR、选择性血管造影等影像学特点 ,采用可脱性球囊和 或钨丝螺旋圈栓塞治疗。 17例病人在治疗后临床症状缓解 ,眼部杂音及眼球震颤消失 ,眼球突出、球结膜水肿在一周后消失。 2例病人出现手术并发症 ,其中 1例死亡。生存的 18例病人全部得到较长时间的随访 ,1例病人出现肢体活动障碍 ,1例病人的术前症状在术后两个月时重新出现。血管内栓塞治疗因其良好的治疗效果及安全性是治疗此类疾病的首选方法 ,避免颈内动脉—海绵窦瘘治疗时产生的直接并发症是改善其预后的最重要因素。
To explore the reasons for the formation of internal carotid artery-cavernous fistula and the efficacy of endovascular embolization and complications prevention measures. Nineteen patients with internal carotid artery-cavernous fistula were analyzed for their clinical manifestations and imaging features such as CT, MR and selective angiography. The patients were treated with detachable balloon and or tungsten spiral coil embolization. After treatment, 17 patients were relieved of clinical symptoms, disappearance of ocular murmur and nystagmus, prominent of the eyeball and disappearance of conjunctival edema in one week. Two patients had surgical complications, of which 1 died. All 18 surviving patients were followed up for a long time. One patient had limb movement disorders and one patient presented with preoperative symptoms two months after surgery. Endovascular embolization is the first choice for the treatment of such diseases because of its good curative effect and safety. To avoid the direct complication of carotid artery-cavernous fistula treatment is the most important factor to improve its prognosis.