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目的探讨介入栓塞治疗颅内小型动脉瘤的临床疗效。方法回顾分析2010年1月~2013年12月六安市人民医院用弹簧圈栓塞治疗的28例病人共30个颅内小型动脉瘤,单纯弹簧圈栓塞23个,需用支架辅助栓塞5个。并发脑积水者术后及时予侧脑室穿刺外引流2例,蛛网膜下腔积血较厚者术后予腰穿释放血性脑脊液5例。结果 30个小型动脉瘤栓塞术中破裂1例,支架诱发血管痉挛及梗塞1例。最终,死亡1例,放弃继续住院治疗2例,其余病例均达到1年至4年的随访,动脉瘤复发1例,其余均未复发。结论弹簧圈栓塞治疗颅内小型动脉瘤效果良好,术后积极处理严重的蛛网膜下腔积血及脑积水,可改善预后。
Objective To investigate the clinical effect of interventional embolization in the treatment of small intracranial aneurysms. Methods A retrospective analysis was performed on 30 small intracranial aneurysms in 28 patients treated with coil embolization in Lu’an People’s Hospital from January 2010 to December 2013. Embolization was performed by using coil alone. Concurrent hydrocephalus postoperative ventricular lateral ventricular drainage in 2 cases, thicker subarachnoid hemorrhage after lumbar puncture in 5 cases of bloody cerebrospinal fluid. Results Thirty cases of small aneurysm were ruptured during embolization in 1 case, and stent-induced vasospasm and infarction in 1 case. In the end, 1 patient died and 2 patients were abandoned for further hospitalization. The remaining cases were followed up for 1 year to 4 years. One case had aneurysm recurrence and the rest did not recur. Conclusion Coil coil embolization has a good effect on small intracranial aneurysms. After the operation, serious subarachnoid hemorrhage and hydrocephalus can be treated actively to improve the prognosis.