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目的探讨采用单纯动脉入路ONYX(医用胶)治疗在海绵窦区硬脑膜海绵窦瘘的意义及栓塞程度对预后的影响。方法回顾性分析2008—2010年我院行动脉入路ONYX治疗的10例患者的手术方式、术中栓塞程度、随访结果及临床意义,10例患者病变均为外伤性,均为择期手术,术中成功弥散ONYX胶,栓塞程度不同,术后随访至1年。结果 3例患者术后残留,行2期治疗,有7例ONYX胶弥散满意,术中造影无残留,分别于随访6个月、1年,3例残留者,瘘口较前分流增多,行2期治疗后,无残留。结论采用经动脉途径予以栓塞治疗的疗效已不容置疑,其优点在于:①可避免经静脉途径栓塞,正常静脉被误栓及栓塞后导致的出血。②术中观察,造影方便,射线量少。③动脉入路操作方便,适用于大多数患者,通过ONYX良好的弥散性能达到完全闭塞瘘口的目的而又不影响血液经静脉窦的正常回流,因此一般可以作为首选。
Objective To investigate the effect of ONYX (medical glue) on the dural cavernous sinus fistula in cavernous sinus and the effect of embolization on prognosis. Methods Retrospectively analyzed the surgical methods, the degree of embolization, the follow-up results and clinical significance of 10 patients treated with ONYX in our hospital during 2008-2010. The lesions of 10 patients were all traumatic. All of them were elective surgery In the successful dispersion of ONYX glue, embolization of different degrees, follow-up to 1 year after surgery. Results Three patients were residual after operation. There were 7 patients with ONYX glue diffusing satisfactorily. There was no residual intraoperative angiography. All patients were followed up for 6 months and 1 year, and 3 patients were residual. The fistula increased more than before, After 2 treatment, no residue. Conclusions The curative effect of embolization via the arterial route has been beyond doubt. The advantages of this method are as follows: (1) It is possible to avoid the embolization of the vein through the vein, the misdiagnosis of the normal vein and the bleeding caused by the embolization. ② intraoperative observation, angiography convenient, less radiation. Â ’¢ arterial access easy to operate, suitable for most patients, through the ONYX good diffusion properties to achieve complete occlusion of the fistula without affecting the normal return of blood through the sinus, it can generally be preferred.