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目的探讨早期超选择动脉内灌注及血管成形术 (PTA)治疗脑血管痉挛 (CVS)的效果。方法对 6例动脉近端狭窄段进行球囊扩张 ,对 3 8例大脑中动脉M2 段、大脑前动脉A1和A2 段痉挛者 ,灌注 0 .3 %罂粟碱 3 0 0～ 40 0ml,观察全脑血管造影和评价神经功能状态。结果复查全脑血管造影见痉挛血管全部有改善 ,术后 48小时临床状态和神经功能状态均得到改善 ,无死亡。术后 3月随访 ,恢复良好 2 7例 ,中度致残、生活能自理 11例。结论对于近端、局限性CVS宜采用PTA ,而对于远端、弥漫性CVS需采用超选择脑动脉内灌注罂栗碱治疗
Objective To investigate the effect of early superselective intra-arterial infusion and angioplasty (PTA) on cerebral vasospasm (CVS). Methods 6 cases of proximal stenotic artery were balloon dilated. 38 cases of spasm of M2 segment of middle cerebral artery and A1 and A2 segments of anterior cerebral artery were infused with 0.3% ~ 40% papaverine. Cerebral angiography and evaluation of neurological status. The results of review Cerebral angiography all spasm vascular improvement, 48 hours after surgery, clinical status and neurological status have been improved, no death. After 3 months of follow-up, good recovery 27 cases, moderate disability, life can take care of 11 cases. Conclusions For proximal and limited CVS, PTA should be used, while for diffuse CVS, supra-selective intracerebral injection of papaverine should be used