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目的探讨早期超选择动脉内灌注及血管成型术(PTA)治疗脑血管痉挛(CVS)。方法对76例CVS病人,在全脑DSA造影中明确痉挛部位,其中6例近端、局限性CVS采用PTA,而远端、弥漫性CVS采用超选择脑动脉内灌注0.3%罂粟碱及溶栓药物治疗,直至血管口径接近正常。结果痉挛血管全部有改善,术后临床状态和神经功能状态均得到改善,无死亡。术后3月随访,Jennett预后良好64例(77.28%),较差(重残或植物状态)12例(18.18%),死亡3例(4.54%),死亡原因均为颅外因素。结论超选择动脉灌注及血管成型术是治疗脑血管痉挛的直接而有效的方法。
Objective To investigate the effects of early superselective intra-arterial infusion and angioplasty (PTA) on cerebral vasospasm (CVS). Methods 76 cases of CVS patients in the whole brain DSA angiography clearly spastic sites, including 6 cases of proximal and localized CVS using PTA, and distal, diffuse CVS using superselective intracerebral perfusion of 0.3% papaverine and thrombolysis Medication, until the blood vessel diameter close to normal. Results All spastic blood vessels improved, postoperative clinical status and neurological status have been improved, no death. After 3 months of follow-up, Jennett had a good prognosis of 64 (77.28%), 12 (18.18%) with poor (severe disability or vegetative state) and 3 deaths (4.54%). The causes of death were all extracranial factors. Conclusion Superselective arterial perfusion and angioplasty are the direct and effective methods for the treatment of cerebral vasospasm.