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目的:探索破裂颅内动脉瘤的血管内介入临床治疗效果。方法:选取我院于2014年7月至2015年7月间收治的150例颅内动脉瘤患者作为临床研究对象,150例患者均接受血管介入栓塞治疗,其中6例患者颅内动脉瘤再次破裂出血。临床对动脉瘤栓塞过程中的破裂进行及时处理,分析颅内动脉瘤破裂的原因与防治。结果:本组6例患者发病期均<3d,处于发病急性期,占同期栓塞动脉瘤的4.0%。6例患者在颅内动脉瘤再次破裂后收缩压均上升至200mm Hg左右,其中第1例和第4例患者出现瞳孔扩大症状,显示动脉瘤破裂,经血管造影确诊为破裂。动脉瘤破裂时机分别为:第1例发生在微导管及导丝导入过程中,第2-5例患者发生在栓塞过程中,最后一例患者发生在最后1枚弹簧圈脱落之时。经过术中栓塞和CT检查发现,第1-5例患者预后恢复状态良好,第6例患者在术后24h内死亡。后经DSA复查,5例患者均未出现动脉瘤再通。结论:在实施血管内介入栓塞手术过程中,颅内动脉瘤再次破裂出血与手术操作、动脉瘤形态以及术中患者血压变动具有密切的联系,针对颅内动脉瘤再次破裂出血及时采取有针对性的防治措施,对动脉瘤进行填塞等,将有助于提高患者预后恢复效果,增强治疗效果。
Objective: To explore the clinical effect of endovascular interventional therapy of ruptured intracranial aneurysms. Methods: A total of 150 patients with intracranial aneurysms admitted from July 2014 to July 2015 in our hospital were enrolled in this study. All of the 150 patients received endovascular embolization, of which 6 patients had ruptured intracranial aneurysms again Bleeding. Clinical rupture of aneurysm embolization in a timely manner to deal with the analysis of intracranial aneurysm rupture causes and prevention and treatment. Results: The onset of 6 patients in this group were all <3d, at the acute stage of onset, accounting for 4.0% of the embolized aneurysms during the same period. Six patients with intracranial aneurysm rupture again after the systolic blood pressure increased to about 200mmHg, including the first and fourth cases of patients with pupil dilation symptoms, aneurysm rupture, angiography confirmed as rupture. The timing of aneurysm rupture was as follows: the first case occurred during the introduction of the microcatheter and guide wire, the second to fifth cases occurred during embolization, and the last case occurred when the last of the coils fell off. After intraoperative embolization and CT examination found that 1-5 cases of prognosis recovery in good condition, the first 6 cases died within 24h after surgery. After DSA review, 5 patients did not appear aneurysm recanalization. Conclusion: During the procedure of endovascular embolization, intracranial aneurysm rupture again with surgical operation, the morphology of aneurysm and intraoperative blood pressure changes are closely linked, once again for the intracranial aneurysm rupture bleeding to take targeted Prevention and treatment measures, aneurysm stuffing, etc., will help to improve the prognosis of patients with recovery and enhance the therapeutic effect.