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目的探讨脑动脉瘤手术中脑血管造影的应用价值。方法有选择地对预计处理难度较大的16例脑动脉瘤患者在手术中进行脑血管造影。患者气管插管全麻后,经右侧股动脉插管,到达手术涉及的颅内动脉。动脉瘤处理完毕,进行血管造影。结果16例中5例急性颅内出血者手术前未造影,手术中经过血管造影证实为颅内动脉瘤。15例(93.8%)经造影证实动脉瘤处理满意,1例(6.2%)眼动脉瘤夹闭后有残留,重新调整动脉瘤夹。本组未见夹闭重要动脉,无手术死亡,无造影相关并发症发生。术中血管造影需要时间25～115min,平均(58±26)min。结论术中脑血管造影有助于及时发现残余动脉瘤、载瘤动脉闭塞,便于立即修正技术缺陷,避免再次手术,降低手术后合并症。
Objective To investigate the value of cerebrovascular angiography in cerebral aneurysm surgery. Methods Sixteen patients with cerebral aneurysm, which are difficult to predict, were selected for cerebrovascular angiography during operation. Patients after tracheal intubation general anesthesia, intubation through the right femoral artery, reaching the intracranial artery involved in surgery. Aneurysms were treated for angiography. Results In 16 cases, 5 cases of acute intracranial hemorrhage had no contrast before operation. The intracranial aneurysm was confirmed by angiography during operation. Fifteen patients (93.8%) were satisfactorily treated with aneurysm by contrast-enhanced angiography. One patient (6.2%) had residual aneurysm after clamping and readjusted the aneurysm clip. No clamped important arteries in this group, no surgical death, no complications related to angiography. Intraoperative angiography takes 25 ~ 115min, an average of (58 ± 26) min. Conclusions Intraoperative cerebral angiography helps to find the residual aneurysm and the occlusion of the parent artery in time, which can facilitate the immediate correction of technical defects, avoid reoperation and reduce postoperative complications.