CAJ | 학술논문

目的：评价替罗非班在急性蛛网膜下腔出血支架辅助栓塞治疗颅内动脉瘤时的效果和安全性。方法：采用支架辅助弹簧圈栓塞或单纯行载瘤动脉内支架植入治疗急性蛛网膜下腔出血颅内动脉瘤患者18例。在植入支架后，术中立刻使用替罗非班静脉推注，后持续泵入24 h，逐渐过渡到常规剂量口服阿司匹林和氯吡格雷。结果：18个动脉瘤患者中，夹层动脉破裂动脉瘤4个，宽颈动脉瘤14个，共植入支架21个，术中未出现支架内血栓。有17例患者在术后24 h 后成功过渡到口服抗血小板聚集药物，在应用替罗非班期间无出血、脑动脉血栓、短暂性脑缺血发作等并发症。结论：对急性动脉瘤性蛛网膜下腔出血患者，术中使用替罗非班对支架辅助栓塞颅内动脉瘤的患者，较为安全有效。
목적：평개체라비반재급성주망막하강출혈지가보조전새치료로내동맥류시적효과화안전성。방법：채용지가보조탄황권전새혹단순행재류동맥내지가식입치료급성주망막하강출혈로내동맥류환자18례。재식입지가후，술중립각사용체라비반정맥추주，후지속빙입24 h，축점과도도상규제량구복아사필림화록필격뢰。결과：18개동맥류환자중，협층동맥파렬동맥류4개，관경동맥류14개，공식입지가21개，술중미출현지가내혈전。유17례환자재술후24 h 후성공과도도구복항혈소판취집약물，재응용체라비반기간무출혈、뇌동맥혈전、단잠성뇌결혈발작등병발증。결론：대급성동맥류성주망막하강출혈환자，술중사용체라비반대지가보조전새로내동맥류적환자，교위안전유효。
Objective:To evaluate the effect and safety of tirofiban in the application of patients with acute subarachnoid hemorrhage treated by stent assisted aneurysm embolization.Methods:18 patients with acute subarachnoid hemorrhage who treated with stent assisted coil embolization or simple stenting of intracranial aneurysms were selected,after the implantation, during the procedure,tirofiban was injected intravenously immediately,then continuous pump for 24 hours,gradual transition to conventional doses of aspirin and clopidogrel.Results:Among patients 18 patients with aneurysms,4 with ruptured dissecting aneurysms,and wide carotid aneurysms in 14 patients,total stent 21,intraoperative stent thrombosis did not occur.There were 17 patients who had successfully transitional to oral anti platelet aggregation agents after 24 h of operation,there were no complications such as bleeding,cerebral arterial thrombosis and transient ischemic attack during the application of tirofiban. Conclusion:In patients with acute aneurysm subarachnoid hemorrhage,intraoperative use tirofiban for patients with stent assisted embolization of intracranial aneurysms is relatively safe and effective.