本文選題：顱內(nèi)動(dòng)脈瘤 + 血管內(nèi)治療��； 參考：《鄭州大學(xué)》2017年碩士論文

【摘要】：目的通過(guò)單中心顱內(nèi)動(dòng)脈瘤介入治療圍手術(shù)期缺血并發(fā)癥的回顧性分析,總結(jié)介入治療相關(guān)缺血并發(fā)癥的發(fā)生原因并探索有效的防治方法。方法收集鄭州大學(xué)第一附屬醫(yī)院神經(jīng)介入科2011年1月至2015年3月共1106例動(dòng)脈瘤栓塞病例資料,共48例患者術(shù)后出現(xiàn)神經(jīng)功能損傷癥狀,對(duì)該48例患者臨床影像學(xué)資料及隨訪結(jié)果進(jìn)行分析,評(píng)估術(shù)中及術(shù)后缺血并發(fā)癥發(fā)生原因并探索有效防治方法。結(jié)果本組48病例中男性17例,女性31例。年齡36~77歲,平均年齡57.1±9.5歲。48例患者動(dòng)脈瘤直徑范圍為2.4~13.0mm,平均5.6±2.6mm。其中37例患者以動(dòng)脈瘤性蛛網(wǎng)膜下腔出血為首發(fā)癥狀入院,入院時(shí)Hunt-Hess分級(jí)分別為Ⅰ級(jí)20例,Ⅱ級(jí)7例,Ⅲ級(jí)6例,Ⅳ級(jí)4例。48例病人手術(shù)均成功實(shí)施。經(jīng)討論分析48例缺血并發(fā)癥臨床及影像學(xué)資料,發(fā)生原因分別為血管痙攣(19例),腦動(dòng)脈血栓形成(16例),腦動(dòng)脈閉塞(6例),術(shù)中低血壓(4例)以及腦水腫(3例)。并發(fā)癥治療措施包括強(qiáng)化抗凝、抗血小板聚集、抗痙攣、升壓、擴(kuò)容等藥物治療及血管內(nèi)溶栓、機(jī)械開(kāi)通治療等措施。48例患者術(shù)后3月隨訪共34例(70.8%)患者m RS評(píng)分≤2,未遺留嚴(yán)重的后遺癥,14例(29.2%)患者m RS2,預(yù)后不良。結(jié)論導(dǎo)致本組48例并發(fā)癥產(chǎn)生原因有腦血管痙攣、腦動(dòng)脈血栓形成、腦動(dòng)脈閉塞、腦水腫及腦低灌注。根據(jù)患者不同癥狀及發(fā)病原因給與不同治療策略及方法,包括脫水、抗凝、抗血小板聚集、抗痙攣、升壓、擴(kuò)容及血管內(nèi)溶栓、機(jī)械開(kāi)通等措施。針對(duì)顱內(nèi)動(dòng)脈瘤介入栓塞術(shù)缺血并發(fā)癥需明確分析并發(fā)癥類型以及發(fā)病機(jī)制才能有效預(yù)防缺血并發(fā)癥的發(fā)生。
[Abstract]:Objective to summarize the causes of ischemic complications associated with interventional therapy of intracranial aneurysms and to explore effective methods to prevent and treat them by retrospective analysis of perioperative ischemic complications in patients with monocentric intracranial aneurysms. Methods from January 2011 to March 2015, 1106 patients with aneurysm embolism were collected from Department of Neurointervention, first affiliated Hospital of Zhengzhou University. The clinical imaging data and follow-up results of 48 patients were analyzed to evaluate the causes of ischemic complications during and after operation and to explore effective methods of prevention and treatment. Results there were 17 males and 31 females in 48 cases. The mean age was 57.1 鹵9.5 years old. The diameter of aneurysms in 48 patients was 2.4 鹵13.0mm, with an average of 5.6 鹵2.6 mm.. Among them, 37 patients were admitted to hospital with aneurysm subarachnoid hemorrhage as the initial symptom. The Hunt-Hess grading was grade 鈪，

本文編號(hào)：1940554