IV、V级颅内动脉瘤破裂急性期的血管内治疗

Endovascular treatment of level IV and V acute ruptured intracranial aneurysm

关键词:  血管内介入治疗  颅内动脉瘤  破裂  蛛网膜下腔出血  高分级

Key words:  [Key words]　intravascular interventional therapy  intracranial aneurysm  rupture  subarachnoid hemorrhage  high-level

摘要:

[摘要]　目的　探讨血管内介入治疗IV、V级动脉瘤破裂出血的疗效。 方法　对大连医科大学附属第一医院收治的23例IV（17例）、V级（6例）破裂动脉瘤患者急诊行血管内栓塞治疗，动脉瘤直径5~21 mm。手术后造影，分析术后疗效。 结果　恢复良好15例，占65％；植物生存者5例，占21％；死亡3例占13％。 结论　对于Hunt-Hess分级IV-V级的患者，在早期行血管介入治疗，能及时制止出血，控制病情，可显著改善颅内动脉瘤出血患者的预后，且介入创伤小，疗效肯定，适应证较宽，可在临床上使用推广。

Abstract:

[Abstract] Objective　To investigate the efficacy of interventional endovascular therapy for level IV and V intracranial aneurysm ruptures.　Methods 23 cases of level IV and V aneurysm rupture, which were treated with emergency endovascular embolization in the First Affiliated Hospital of Dalian Medical University, were retrospectively analyzed.　Results There were 15 cases of good recovery (65%), 5 cases of plant survival (21%) and 3 cases of death (13%).　Conclusion Early interventional endovascular treatment can stop the bleeding in time and control the disease for IV-V level patients. It can significantly improve the prognosis of patients with intracranial aneurysm hemorrhage. Endovascular therapy has advantages of less trauma, better healing effect and wide adaptation and thus can be promoted in clinical practice.