CAJ | 학술논문

目的：探讨吲哚菁绿荧光血管造影在颅内动脉瘤夹闭术中的应用,提高手术安全性。方法回顾性分析该科室50例术中应用荧光血管造影的颅内动脉瘤患者资料。术中动脉瘤夹闭前后均行吲哚菁绿荧光血管造影,术后行头颅 CT 血管造影(CTA)和(或)数字减影血管造影(DSA)随访检查,观察治疗效果并采用格拉斯哥(GOS)评分进行术后随访。结果术中吲哚菁绿荧光血管造影发现动脉瘤颈残留3例,载瘤动脉及动脉瘤临近分支血管狭窄各1例,吲哚菁绿荧光造影“假阴性”2例,均根据情况调整动脉瘤夹,再次荧光造影证实动脉瘤夹闭满意,术后复查 CTA 和(或)DSA 证实术中荧光血管造影结果。随访40例患者(3~6个月)GOS 评分5分30例,4分7例,3分2例,2分1例。结论吲哚菁绿荧光血管造影对于术中判断动脉瘤夹闭情况、载瘤动脉及动脉瘤临近分支通畅情况有重要的参考价值,可提高手术安全性,从而有效改善患者预后。
목적：탐토신타정록형광혈관조영재로내동맥류협폐술중적응용,제고수술안전성。방법회고성분석해과실50례술중응용형광혈관조영적로내동맥류환자자료。술중동맥류협폐전후균행신타정록형광혈관조영,술후행두로 CT 혈관조영(CTA)화(혹)수자감영혈관조영(DSA)수방검사,관찰치료효과병채용격랍사가(GOS)평분진행술후수방。결과술중신타정록형광혈관조영발현동맥류경잔류3례,재류동맥급동맥류림근분지혈관협착각1례,신타정록형광조영“가음성”2례,균근거정황조정동맥류협,재차형광조영증실동맥류협폐만의,술후복사 CTA 화(혹)DSA 증실술중형광혈관조영결과。수방40례환자(3~6개월)GOS 평분5분30례,4분7례,3분2례,2분1례。결론신타정록형광혈관조영대우술중판단동맥류협폐정황、재류동맥급동맥류림근분지통창정황유중요적삼고개치,가제고수술안전성,종이유효개선환자예후。
Objective To improve the safety of surgery,the application of indocyanine green fluorescein(ICG)angiography in intracranial aneurysm surgery was investigated.Methods Fifty cases of intracranial aneurysms were retrospectively analyzed.All the patients were received ICG angiography before and after intracranial aneurysm clipping.The efficiency of the surgery was evalu-ated with CT angiography(CTA)and(or)digital subtraction angiography(DSA).The postoperative follow-up was conducted using Glasow outcomes score(GOS).Results Of the 50 patients,3 cases of aneurysmal neck remnant,one case of parent arteries steno-sis,one case of nearby branch stenosis and two cases of “false-negative”were observed after ICG angiography.The clips were adjus-ted until the satisfactory blood flew was restored.Postoperative CTA and(or)DSA confirmed the results of intraoperative ICG an-giography.Of the 40 patients underwent follow-up,GOS score was 5 in 30 cases,4 in 7 case,3 in 2 case and 2 in 1 case.Conclusion ICG angiography is a useful way to assess the clipping of aneurysms,blood flew of parent arteries and nearby branches during the aneurysm surgery.It could raise the safety of surgery and further improve the clinical outcomes of intracranial aneurysms.