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目的总结颅内动脉瘤栓塞术中突发性颈内动脉闭塞性痉挛的紧急处理。方法 681例颅内动脉瘤栓塞术中,14例发生颈内动脉闭塞性痉挛。早期的8例采用经导引导管灌注罂粟碱和尿激酶等常规治疗方法处理;后期的6例采用动脉内灌注利多卡因和尿激酶等。结果常规方法治疗的8例中,仅5例痉挛部分解除,均未完成栓塞。采用利多卡因治疗的6例中,痉挛完全解除5例,4例完成栓塞,恢复正常。结论颈内动脉闭塞性痉挛常规治疗效果极差,采用利多因动脉内灌注可取得较好效果。
Objective To summarize the emergency treatment of sudden internal carotid artery occlusive spasm in intracranial aneurysm embolization. Methods 681 cases of intracranial aneurysm embolization, 14 cases of internal carotid artery occlusive spasm. In the early 8 cases, cathepsin and urokinase were administered by catheterization. In the latter 6 cases, intra-arterial infusion of lidocaine and urokinase were used. Results Of the 8 cases treated by conventional method, only 5 cases were partially relieved of spasm, and no embolization was completed. Of the 6 cases treated with lidocaine, spasticity was completely relieved in 5 cases, and embolization was completed in 4 and returned to normal. Conclusion Conventional treatment of internal carotid artery occlusive spasm is very poor. Adopting liduo intra-arterial infusion can achieve good results.