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目的 总结电解式可脱弹簧圈 (GDC)栓塞颅内动脉瘤的并发症及防治经验。方法 用GDC栓塞动脉瘤 10 8例 ,有 2 0例出现 2 4例次并发症 ,对其发生的原因及防治方法进行回顾性分析。结果 并发症中 ,动脉瘤破裂 10例次 ,过度栓塞 5例次 ,弹簧圈脱出动脉瘤 5例次 ,血栓形成 4例次。动脉瘤破裂后立即中和肝素 ,并力争继续栓塞止血 ,10例中死亡 4例、重度残疾 1例、轻度残疾 1例 ,其余 4例恢复正常。采用扩血管、溶栓、抗凝和升压等处理对过度栓塞、弹簧圈脱出和血栓形成进行治疗 ,5例过度栓塞中死亡 1例、4例恢复正常 ;弹簧圈脱出动脉瘤 5例中重度残疾 1例、轻度残疾1例、其余无后遗症 ,血栓形成 4例中死亡 1例、遗有感觉性失语 1例 ,余 2例恢复正常。本组死亡 5例(4.6 % ) ,永久性神经功能缺失 4例。结论 正确处理术中并发症、深刻理解动脉瘤和载瘤动脉的解剖形态特点、提高栓塞技术有助于减少并发症、提高治愈率。
Objective To summarize the complications and prevention and treatment of intracranial aneurysm embolization with electrolytically detachable coil (GDC). Methods 108 aneurysms were embolized with GDC, 24 cases were complicated by 20 cases, and their causes and prevention and treatment were retrospectively analyzed. Results Complications of aneurysm rupture in 10 cases, over embolization in 5 cases, coil out of aneurysm in 5 cases, thrombosis in 4 cases. Immediately after the rupture of the aneurysm, heparin was neutralized and an attempt was made to continue the embolization and stop bleeding. Among 10 patients, 4 died, 1 had severe disability, 1 had mild disability, and the remaining 4 returned to normal. The treatment of excessive embolism, coil prolapse and thrombosis was performed by vasodilation, thrombolysis, anticoagulation and blood pressure treatment. One patient died of excessive embolization in 5 patients and the other 4 patients returned to normal. 1 case of disability, 1 case of mild disability, the other without sequelae, 1 case of thrombosis in 4 cases, 1 case of sensory aphasia left, and 2 cases returned to normal. The group died in 5 cases (4.6%), 4 cases of permanent neurological deficit. Conclusion The correct treatment of intraoperative complications, a deep understanding of aneurysm and the parent artery of the anatomical features, improve the embolization technology helps to reduce complications and improve the cure rate.