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目的探讨>70岁老年人颅内动脉瘤破裂血管内栓塞治疗的临床疗效。方法选取45例>70岁经CT检查确诊为蛛网膜下腔出血且全脑血管造影明确诊断动脉瘤破裂出血的患者,按Hunt-Hess分级,Ⅱ级15例,Ⅲ级17例,Ⅳ级及以上13例。经数字减影造影(DSA)发现动脉瘤48个。依据动脉瘤的不同结构和不同位置,采取单纯弹簧圈栓塞、支架结合栓塞与球囊辅助栓塞;术后予“3H”、“尼莫地平”预防血管痉挛治疗,同时治疗基础疾病。结果成功栓塞44个动脉瘤,栓塞成功率为91.67%。术后评分优良37例,轻度残疾5例,重度残疾1例,死亡2例。结论血管内栓塞可以有效治疗>70岁患者破裂颅内动脉瘤,防止动脉瘤再次破裂出血,临床效果显著。
Objective To investigate the clinical effect of ruptured endovascular embolization of intracranial aneurysms in 70-year-old patients. Methods Forty-five patients> 70 years old were diagnosed as subarachnoid hemorrhage by CT and were diagnosed aneurysm rupture by CT angiography. According to Hunt-Hess classification, 15 cases were grade Ⅱ, 17 cases were grade Ⅲ, Above 13 cases. 48 aneurysms were found by digital subtraction angiography (DSA). According to the different structures and different positions of aneurysm, simple coil embolization, stent combined embolization and balloon-assisted embolization were used to prevent vasospasm after treatment with “3H” and “nimodipine” . Results Forty-four aneurysms were successfully embolized and the success rate of embolization was 91.67%. Postoperative excellent score 37 cases, 5 cases of mild disability, 1 case of severe disability and 2 cases of death. Conclusions Endovascular embolization can effectively treat ruptured intracranial aneurysms in patients> 70 years old and prevent aneurysm rupture again. The clinical effect is remarkable.