CAJ | 학술논문

目的:汇总分析弹簧圈栓塞治疗脑动脉瘤的临床效果.方法:由作者应用计算机检索1990/2008 PubMed数据(http://www.ncbi.nlm.nih.gov/PubMed)及万方数据库(http://www.wanfangdata.com.cn)有关弹簧圈栓塞治疗脑动脉瘤的研究,英文检索词为"aneurysm of brain,spring ring interventional therapy,embolism",中文检索词为"脑动脉瘤,栓塞,弹簧圈,血管内治疗".排除重复性研究.计算机初检得到54篇文献,根据纳入标准保留14篇进一步归纳总结.结果:纳入的14篇文献显示,栓塞前需行全脑血管造影了解颅内循环情况,并测量动脉瘤颈、瘤体大小.微导管到位后,一般不行超选择造影,以避免动脉瘤破裂.选择合适的导管、导丝至关重要.要选择与动脉瘤大小相当直径的弹簧圈,放置时要尽可能使其沿着动脉瘤的壁盘旋缠绕.形成初步"筐架",以利于其他弹簧圈在"筐架"中盘旋.尽量做到弹簧圈在动脉瘤内致密填塞,以免动脉瘤复发.最后一个弹簧圈不宜过长,避免难以完全填入.弹簧圈在解脱前均应造影证实其在动脉瘤内,确保载瘤动脉通畅.操作过程要轻柔,导丝、导管前进一段路程后要注意轻轻回撤少许,以卸掉因所过弯曲较多而产生的张力,防止产生"疏忽前跃"现象,导致刺破动脉瘤.结论:弹簧圈血管内栓塞是治疗脑动脉瘤较理想的方法,具有微创、安全可靠、效果确切的特点.
목적:회총분석탄황권전새치료뇌동맥류적림상효과.방법:유작자응용계산궤검색1990/2008 PubMed수거(http://www.ncbi.nlm.nih.gov/PubMed)급만방수거고(http://www.wanfangdata.com.cn)유관탄황권전새치료뇌동맥류적연구,영문검색사위"aneurysm of brain,spring ring interventional therapy,embolism",중문검색사위"뇌동맥류,전새,탄황권,혈관내치료".배제중복성연구.계산궤초검득도54편문헌,근거납입표준보류14편진일보귀납총결.결과:납입적14편문헌현시,전새전수행전뇌혈관조영료해로내순배정황,병측량동맥류경、류체대소.미도관도위후,일반불행초선택조영,이피면동맥류파렬.선택합괄적도관、도사지관중요.요선택여동맥류대소상당직경적탄황권,방치시요진가능사기연착동맥류적벽반선전요.형성초보"광가",이리우기타탄황권재"광가"중반선.진량주도탄황권재동맥류내치밀전새,이면동맥류복발.최후일개탄황권불의과장,피면난이완전전입.탄황권재해탈전균응조영증실기재동맥류내,학보재류동맥통창.조작과정요경유,도사、도관전진일단로정후요주의경경회철소허,이사도인소과만곡교다이산생적장력,방지산생"소홀전약"현상,도치자파동맥류.결론:탄황권혈관내전새시치료뇌동맥류교이상적방법,구유미창、안전가고、효과학절적특점.
OBJECTIVE:To summarize and analyze the clinical outcomes of coil embolization for treating cerebral aneurismal METHODS:Authors retrieved PubMed Database(http://www.ncbi.nlm.nih.gov/PubMed)and Wanfang Database(http://www wanfangdata.com.cn)by using a computer for articles concerning coil embolization for treating cerebral aneurismal published from 1990 to 2008.The key words were"aneurysm of brain,spring ring interventional therapy,embolism"in English,and"cerebral aneurysm,embolism,circlip ring,endovascular treatment"in Chinese Duplicated studies were excluded.A total of54 articles were obtained by primary screening.According to inclusion criteria,14 articles were further summarized.RESULTS:The included 14 articles exhibited that aortocranial angiography was conducted before embolism to understand intracalvarium circulation and to measure aneurysm neck and size.Following microtubular in position,superselective angiography was not performed to avoid aneurysm rupture.It was important to select suitable catheter and guide wire.Spring ring with the same diameter as aneurysm size was selected When placed it,it should be twisted around the wall of aneurysm to form a primary"frame",which was beneficial for spiral of other spring rings in the"frame".Try to make spring ring densely plugged in aneurysm to avoid aneurysm relapse.The last spring ring should not be too long so as to avoid difficulty in complete filling-in.Before disengage,the spring ring should undergo visualization to verify that it was in the aneurysm to ensure the patency of parent artery.The operation should be light and soft Following proceeding a path,the guide wire and catheter should be slightly withdrawn a part to unload the tension induced by bending,resulting in avoiding"negligence-induced leaping forwards"that may pierce the aneurysm.CONCLUSION:Spring ring endovascular embolization is an ideal method to treat cerebral aneurysm,with characteristics of microinvasion,security,reliability and definite outcomes .