本文關鍵詞： 腦動脈瘤 介入治療 療效　出處：《青島大學》2017年碩士論文　論文類型：學位論文

【摘要】：隨著人們生活水平的提高,人類壽命的不斷增長,人口老齡化日趨嚴重,腦血管病發(fā)病率增高,已成為造成人類死亡的三大因素之一。顱內動脈瘤是腦血管常見病癥,發(fā)病率很高,僅次于腦梗塞和高血壓腦出血。腦動脈瘤是神經內科一種常見的疾病,其發(fā)病原因為腦內的動脈局部的一樣擴張,引起的血管壁的異常突起,臨床上通常為蛛網膜下腔出血首次就診疾病。顱內動脈瘤好發(fā)年齡為40-60歲,女性略高于男性,表現(xiàn)為顱內出血、再出血、血管痙攣,具有較高的死亡率和致殘率。而以往的手術夾閉AN(特別是急性期AN)具有較大的手術風險和死亡率。是目前腦血管疾病中致死、致殘率最高的疾病。顱內動脈瘤的致殘率和死亡率都比較高,對顱內動脈瘤采取何種有效的治療辦法成為臨床研究的重要課題。SAH治療方式有三種,傳統(tǒng)的開顱夾閉治療,微創(chuàng)腦血造影管填塞術,另外就是傳統(tǒng)保守治療。SAH的死亡率、致殘率還是很高的,三成患者在動脈瘤破裂之前還未得到有效診治就已經死亡,三成患者雖然經過積極的手術治療,但是因為手術失敗或者術中風險并發(fā)癥,或者術后并發(fā)癥死亡,只有約三分之一的患者可以存活,但是仍舊會遺留肢體癱瘓或者腦功能缺失。利用介入神經放射學方法治療顱內動脈瘤近年來發(fā)展迅速,使某些傳統(tǒng)手術難以夾閉的動脈瘤獲得了一種新的有效治療方法,介入神經放射學方法治療顱內動脈瘤減少上訴并發(fā)癥。并且近些年,由于神經影像學、計算機技術以及栓塞技術和栓塞材料的迅速發(fā)展,介入神經放射學血管內介入治療(Endovascular Interventional Treatment)AN取得較大的成功,已經成為一門獨立的學科,由于其具有微創(chuàng)性、安全性、有效性等優(yōu)點,已經被越來月廣泛的應用于臨床治療當中。目前,采用微創(chuàng)診治手段,早期發(fā)現(xiàn)顱內動脈瘤并及時采取相關治療是預防和減少顱內動脈瘤發(fā)病及致殘率的有效手段,具有重要的臨床意義。目的:分析應用顱內動脈瘤介入治療的效果。方法:通過血管內介入栓塞治療,對50例顱內動脈瘤患者進行研究,分析患者的治療效果。結果:選取的50例患者經血管介入方法治療后,良好率達到84%,輕殘率為10%,重殘率為6%,無植物生存和死亡。3例患者出現(xiàn)腦梗死,6例出現(xiàn)偏癱癥狀,經治療后均治愈。頭暈、頭痛癥狀患者經過對癥治療后緩解。隨訪十個月,均未出現(xiàn)再出血,47例患者瘤體栓塞完全,載流動脈通暢,尚無復發(fā)現(xiàn)象。結論:血管內介入治療對顱內動脈瘤患者具有較為顯著的治療效果,安全有效,可以作為SAH治療的最佳方案。
[Abstract]:With the improvement of people's living standard and the increase of human life span, the aging of population is becoming more and more serious, and the incidence of cerebrovascular disease is increasing. Intracranial aneurysm is a common cerebrovascular disease with a high incidence, second only to cerebral infarction and hypertensive cerebral hemorrhage. Cerebral aneurysm is a common disease in neurology. The cause of the disease is the same dilatation of the cerebral artery, the abnormal protuberance of the vascular wall, usually the first visit disease of subarachnoid hemorrhage in clinic. The common age of intracranial aneurysm is 40-60 years old. Women are slightly higher than men, showing intracranial hemorrhage, re-bleeding, vasospasm. Has a high mortality and disability rate. But the previous operation clip ANs (especially acute ANs) has a greater operational risk and mortality. It is the current cerebrovascular disease death. The morbidity and mortality of intracranial aneurysms are relatively high. The effective treatment of intracranial aneurysms has become an important topic in clinical research. There are three kinds of SAH treatment methods. Traditional craniotomy clipping treatment, minimally invasive cerebral angiography tube tamponade, and traditional conservative treatment. SAH mortality, the disability rate is still very high. Thirty percent of the patients had died before the aneurysm ruptured effectively, and 30 percent of the patients had died because of the failure of the operation or the risk of complications during the operation, or the postoperative complications, although the patients had undergone active surgical treatment. Only about 1/3 patients can survive, but still have limb paralysis or brain dysfunction. Interventional neuroradiology has developed rapidly in recent years in the treatment of intracranial aneurysms. It is a new and effective method to treat aneurysms which are difficult to be clipped by traditional operation. Interventional neuroradiology for intracranial aneurysms reduces the appeal complications. And in recent years, because of neuroimaging. The rapid development of computer technology as well as embolization technology and embolization materials. Endovascular Interventional Treatment)AN was successfully treated by interventional neuroradiology and intravascular interventional therapy. Has become an independent subject, because of its advantages of minimally invasive, safe, effective and so on, has been more and more widely used in clinical treatment. At present, the use of minimally invasive methods of diagnosis and treatment. Early detection and timely treatment of intracranial aneurysms is an effective means to prevent and reduce the incidence and disability of intracranial aneurysms. Objective: to analyze the effect of interventional therapy for intracranial aneurysms. Methods: 50 patients with intracranial aneurysms were studied by endovascular embolization. Results: the good rate was 84%, the mild disability rate was 10 and the severe disability rate was 6%. There were 6 cases of cerebral infarction and 6 cases of hemiplegia without vegetative survival and death, all of them were cured after treatment. The patients with dizziness and headache were relieved after symptomatic treatment. All the patients were followed up for 10 months and no further bleeding was found. 47 patients with complete embolization of the tumor, flow carrying artery unobstructed, no recurrence phenomenon. Conclusion: endovascular interventional therapy for intracranial aneurysms has a more significant effect, safe and effective. It can be used as the best treatment for SAH.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743

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本文編號：1491876