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目的探讨在脑血管疾病手术中脑血管造影的应用价值。方法对38例脑血管病病人在手术中进行脑血管造影。38例中男21例,女17例,年龄3岁~53岁,平均(34±9)岁。38例中动静脉畸形(AVM)27例,畸形血管团大小为2~8cm,其中巨大AVMs(直径≥6cm)7例(25·9%);动脉瘤11例,其中巨大动脉瘤(直径≥2·5cm)3例。手术前Hunt-Hess分级情况:1级4例,2级4例,3级3例。病人经气管插管全麻后经右侧股动脉插管,到达手术涉及的颅内动脉。病灶处理完毕后进行血管造影。结果38例中9例急性颅内出血病人手术前未造影,手术中经过血管造影证实,其中7例为AVMs,另外2例证实为动脉瘤。36例(94·7%)经过造影证实病变处理满意,1例(9·0%)眼动脉瘤夹闭后有残留,重新调整动脉瘤夹;1例(3·7%)后颅窝AVM残存,病人无重要动脉被夹闭,无手术死亡病例,无造影相关并发症发生。术中血管造影需要时间为20~125min,平均(53±22)min。结论术中脑血管造影有助于医师及时发现残余动脉瘤或AVM,载瘤动脉闭塞,立即修正技术缺陷,避免再次手术,降低手术后合并症。
Objective To explore the value of cerebrovascular angiography in cerebrovascular diseases. Methods Thirty-eight patients with cerebrovascular disease underwent cerebrovascular angiography during operation. Among the 38 cases, 21 were males and 17 were females, ranging in age from 3 years to 53 years (mean, 34 ± 9 years). There were 27 cases of AVM (AVM), 2 ~ 8 cm in size, including 7 cases (25.9%) of huge AVMs (diameter ≥ 6 cm), 11 aneurysms 2 · 5cm) in 3 cases. Preoperative Hunt-Hess grading: 1 in 4 cases, 2 in 4 cases, 3 cases in 3 cases. After tracheal intubation, the patient was intubated through the right femoral artery and reached the intracranial artery involved in the operation. Angiography was performed after the lesion was treated. Results Of the 38 patients, 9 patients with acute intracranial hemorrhage had no angiography before angiography and were confirmed by angiography during operation. Among them, 7 were AVMs and the other 2 were aneurysms. Thirty-six patients (94.7%) were satisfactorily treated by angiography and 1 patient (9.0%) had residual aneurysm after clipping, and the aneurysm was readjusted. One case (3.7%) posterior fossa AVM Survival, patients with no important artery is clipped, no surgical deaths, no complications related to angiography. Intraoperative angiography takes 20 ~ 125min, an average of (53 ± 22) min. Conclusions Intraoperative cerebral angiography can help doctors to detect residual aneurysms or AVMs in a timely manner and occlude the artery of the host tumor. The technique defects can be corrected immediately to avoid reoperation and reduce postoperative complications.