50例颅内动脉瘤的介入治疗分析

发布时间：2018-02-05 02:37

本文关键词： 脑动脉瘤介入治疗疗效　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：随着人们生活水平的提高,人类寿命的不断增长,人口老龄化日趋严重,脑血管病发病率增高,已成为造成人类死亡的三大因素之一。颅内动脉瘤是脑血管常见病症,发病率很高,仅次于脑梗塞和高血压脑出血。脑动脉瘤是神经内科一种常见的疾病,其发病原因为脑内的动脉局部的一样扩张,引起的血管壁的异常突起,临床上通常为蛛网膜下腔出血首次就诊疾病。颅内动脉瘤好发年龄为40-60岁,女性略高于男性,表现为颅内出血、再出血、血管痉挛,具有较高的死亡率和致残率。而以往的手术夹闭AN(特别是急性期AN)具有较大的手术风险和死亡率。是目前脑血管疾病中致死、致残率最高的疾病。颅内动脉瘤的致残率和死亡率都比较高,对颅内动脉瘤采取何种有效的治疗办法成为临床研究的重要课题。SAH治疗方式有三种,传统的开颅夹闭治疗,微创脑血造影管填塞术,另外就是传统保守治疗。SAH的死亡率、致残率还是很高的,三成患者在动脉瘤破裂之前还未得到有效诊治就已经死亡,三成患者虽然经过积极的手术治疗,但是因为手术失败或者术中风险并发症,或者术后并发症死亡,只有约三分之一的患者可以存活,但是仍旧会遗留肢体瘫痪或者脑功能缺失。利用介入神经放射学方法治疗颅内动脉瘤近年来发展迅速,使某些传统手术难以夹闭的动脉瘤获得了一种新的有效治疗方法,介入神经放射学方法治疗颅内动脉瘤减少上诉并发症。并且近些年,由于神经影像学、计算机技术以及栓塞技术和栓塞材料的迅速发展,介入神经放射学血管内介入治疗(Endovascular Interventional Treatment)AN取得较大的成功,已经成为一门独立的学科,由于其具有微创性、安全性、有效性等优点,已经被越来月广泛的应用于临床治疗当中。目前,采用微创诊治手段,早期发现颅内动脉瘤并及时采取相关治疗是预防和减少颅内动脉瘤发病及致残率的有效手段,具有重要的临床意义。目的:分析应用颅内动脉瘤介入治疗的效果。方法:通过血管内介入栓塞治疗,对50例颅内动脉瘤患者进行研究,分析患者的治疗效果。结果:选取的50例患者经血管介入方法治疗后,良好率达到84%,轻残率为10%,重残率为6%,无植物生存和死亡。3例患者出现脑梗死,6例出现偏瘫症状,经治疗后均治愈。头晕、头痛症状患者经过对症治疗后缓解。随访十个月,均未出现再出血,47例患者瘤体栓塞完全,载流动脉通畅,尚无复发现象。结论:血管内介入治疗对颅内动脉瘤患者具有较为显著的治疗效果,安全有效,可以作为SAH治疗的最佳方案。
[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.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743

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