CAJ | 학술논문

目的探讨颅内动脉瘤囊内栓塞治疗中并发症的发生原因及预防和处理的方法。方法用可控性弹簧圈栓塞治疗的动脉瘤120例(125个)，其中22例(23个动脉瘤)发生并发症25例次(包括动脉瘤破裂、载瘤动脉血栓形成或其它原因所致的闭塞以及弹簧圈脱出动脉瘤)，对其发生的原因及预防和治疗方法进行了回顾性分析。结果 22例出现并发症的动脉瘤患者中，动脉瘤破裂出血9例次，过度栓塞7例次，弹簧圈脱出7例次，血栓形成2例次。因并发症而死亡4例(3.33%)，永久性神经功能障碍2例(1.67%)；一过性神经功能障碍4例(3.33%)。栓塞技术、术中判断和处理的正确与否、动脉瘤和载瘤动脉的特点以及栓塞材料与并发症的发生和结局相关。结论栓塞技术的提高，动脉瘤和载瘤动脉解剖的深入理解，术中发生情况的正确处理、栓塞材料的改进，有助于降低并发症的发生率改善其预后。
목적탐토로내동맥류낭내전새치료중병발증적발생원인급예방화처리적방법。방법용가공성탄황권전새치료적동맥류120례(125개)，기중22례(23개동맥류)발생병발증25례차(포괄동맥류파렬、재류동맥혈전형성혹기타원인소치적폐새이급탄황권탈출동맥류)，대기발생적원인급예방화치료방법진행료회고성분석。결과 22례출현병발증적동맥류환자중，동맥류파렬출혈9례차，과도전새7례차，탄황권탈출7례차，혈전형성2례차。인병발증이사망4례(3.33%)，영구성신경공능장애2례(1.67%)；일과성신경공능장애4례(3.33%)。전새기술、술중판단화처리적정학여부、동맥류화재류동맥적특점이급전새재료여병발증적발생화결국상관。결론전새기술적제고，동맥류화재류동맥해부적심입리해，술중발생정황적정학처리、전새재료적개진，유조우강저병발증적발생솔개선기예후。
Objective　To explore the causes of countermeasures to the accidents in intracranial aneurysm embolization with controllable coils (mechanical detachable spiral， MDS， and/or Guglielmi detachable coil， GDC).　Methods　From March 1995 to July 1999, 120 patients with intracranial aneurysm (125 aneurysms) were embolized with controllable coils. 25 accidents including aneurysm bleeding， thrombosis or occlusion, and coil end protruding to the parent artery of aneurysm，which occurred in 22 patients (23 aneurysms) during treatment were reviewed.　Results　Among the 25 accidents, concomitant and secondary, there were 9 aneurysm ruptures，7 over-embolizations， 7 coil end protrudings to the parent artery，and 2 thromboses. The accidents resulted in 4 deaths (3.33%，4/120)， 2 permanent neurological deficits (1.67%), and 4 transitory neurological deficits (3.33%). The accidents were related to tho embolizing technique，tho pattern of aneurysm and its parent artery，the observation and management during embolization, and the limitation of coils.　Conclusions　 Skilled emboli zing technique，better understanding of aneurysm and its parent artery angioanatomy，correct judgment during treatment and improved embolic material are helpful to reduce the accidents and the their effect.