CAJ | 학술논문

目的探讨外伤性颈内动脉海绵窦瘘(traumatic carotid -cavernous fistulas,TCCF)可脱性球囊栓塞术的技术要点并客观评价其治疗效果. 方法以可脱性球囊栓塞治疗59例TCCF,共进行栓塞术64次.随访时间3个月～2年. 结果 48例成功闭塞瘘口且保留颈内动脉通畅,颈内动脉通畅率为81％；11例瘘口及颈内动脉被同时闭塞.5例在治疗后3d内复发(复发率为8％),再次行栓塞术,其中1例出现栓塞后失明,再次行球囊栓塞后成功闭塞,但视力未恢复；1例术后3d出现脑内血肿,急诊再次行栓塞,闭塞颈内动脉和瘘口,但左侧肢体轻瘫. 结论以可脱性球囊栓塞是治疗TCCF的可靠方法,具有损伤小、安全性高的特点；术后应严密观察病情,若出现复发症状,应及时复查脑血管造影及头颅CT,急诊处理复发的TCCF.
목적 탐토외상성경내동맥해면두루(traumatic carotid -cavernous fistulas,TCCF)가탈성구낭전새술적기술요점병객관평개기치료효과. 방법 이가탈성구낭전새치료59례TCCF,공진행전새술64차.수방시간3개월～2년. 결과 48례성공폐새루구차보류경내동맥통창,경내동맥통창솔위81％；11례루구급경내동맥피동시폐새.5례재치료후3d내복발(복발솔위8％),재차행전새술,기중1례출현전새후실명,재차행구낭전새후성공폐새,단시력미회복；1례술후3d출현뇌내혈종,급진재차행전새,폐새경내동맥화루구,단좌측지체경탄. 결론 이가탈성구낭전새시치료TCCF적가고방법,구유손상소、안전성고적특점；술후응엄밀관찰병정,약출현복발증상,응급시복사뇌혈관조영급두로CT,급진처리복발적TCCF.
Objective To investigate the main technical points of detachable balloon in management of traumatic carotid-cavernous fistulas (TCCF) and evaluate objectively the clinical outcome.Methods A total of 59 patients with TCCF were treated with detachable balloons,which involved 64 embolization procedures.Follow-up ranged from 3 months to 2 years. Results Forty-eight patients with TCCF (81％) were successfully occluded with patency of internal carotid artery.The rest 11 patients were obstructed in both the fistula and the internal carotid artery.Recurrent TCCF was found within three days after embolization in five patients (with a recurrence rate of 8％ ) who underwent further embolization,of whom one patient went blind after the procedtre and the eyesight showed no recovery even after another embolization with balloon for successful occlusion of the fistula; one patient presented with intracerebral hematoma at day 3 postoperatively and underwent emergency embolization again to occlude the internal carotid artery and fistula,with slight paralysis of the left limb. Conclusions Embolization of TCCF with detachable balloon is a reliable treatment,which is characterized by slight injury and high safety.However,the disease' s development should be strictly observed after the treatment.In the case of recurrence of symptoms,brain angiography and CT scanning should be rechecked timely and emergency treatment should be performed.