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目的 评估脑动脉瘤电解脱铂金圈 (EDPC)栓塞治疗的临床疗效 ,探讨手术时机及术中操作注意事项。资料与方法 1999年 2月～ 2 0 0 3年 2月用EDPC栓塞治疗脑动脉瘤 32例。其中 30例为蛛网膜下腔出血 (SAH)患者 ,术前Hunt&Hess分级 :19例为Ⅰ级 ,6例为Ⅱ级 ,5例为Ⅳ～Ⅴ级。 32例 33个动脉瘤 ,均采用EDPC治疗。EDPC为美国波士顿科学国际有限公司下属Target公司生产的GDC和德国Dendron公司生产的EDC两种。为了安全、准确地栓塞动脉瘤 ,在放置铂金圈过程中及解脱前均行透视监视和数字减影血管造影 ,以监控栓塞的动脉瘤全程。结果 32例脑动脉瘤患者共 33个动脉瘤中 ,31个动脉瘤栓塞成功 ,2个因载瘤动脉严重痉挛失败 ,占 6 %。按动脉瘤的填塞程度分为 :完全填塞 2 4例 (72 .7% ) ,不完全填塞 6例 (18.1% ) ;2例梭形动脉瘤行载瘤动脉栓塞。非血栓性并发症发生率 9%。无血栓形成及血栓性栓塞并发症 ,亦无神经功能障碍、瘫痪和死亡等永久性并发症。结论 EDPC栓塞治疗动脉瘤是目前比较理想的治疗方法 ,其创伤小 ,操作简便 ,术后恢复快 ,可达到近似外科手术的效果
Objective To evaluate the curative effect of EDPC embolization on cerebral aneurysms and to discuss the timing and intraoperative operative considerations. Materials and Methods From February 1999 to February 2003, 32 cases of cerebral aneurysms were treated with EDPC embolization. Thirty of them were patients with subarachnoid hemorrhage (SAH). The preoperative Hunt & Hess grade was 19 grade Ⅰ, 6 grade Ⅱ, and 5 grade Ⅳ to Ⅴ. 32 cases of 33 aneurysms were treated with EDPC. EDPC for the United States Boston Scientific International Co., Ltd. under the GDC produced by Target and Germany Dendron produced two EDC. In order to embolize the aneurysm in a safe and accurate manner, fluoroscopy and digital subtraction angiography were performed before and during platinum ring placement to monitor the entire embolized aneurysm. Results Thirty-two aneurysms of 32 patients with cerebral aneurysm were successful in embolization of thoracic aneurysm, and 2 failed in severe aneurysm of parent artery, accounting for 6%. According to the degree of aneurysm filling, 24 cases (72.7%) were completely stuffed, 6 cases (18.1%) were incompletely stuffed, and 2 cases had spindle aneurysm embolization. Non-thrombotic complication rate 9%. No thrombosis and thrombotic embolism complications, nor neurological disorders, paralysis and death and other permanent complications. Conclusion EDPC embolization is an ideal treatment for aneurysms. It has the advantages of less trauma, simple operation and quick recovery after operation, and can achieve approximate surgical results