医学临床研究
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医学临床研究  2020, Vol. 37 Issue (11): 1708-1710    DOI: 10.3969/j.issn.1671-7171.2020.11.033
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荧光血管造影辅助前循环动脉瘤夹闭术治疗前循环动脉瘤的疗效分析
曾群, 江辉, 徐凡, 姜维民, 罗可
湖南省湘潭市中心医院神经外科,湖南 湘潭 411100
Clinical Analysis of Anterior Circulation Aneurysm Clipping Assisted by Fluorescein Angiography in the Treatment of Anterior Circulation Aneurysm
ZENG Qun, JIANG Hui, XU Fan, et al
Department of Neurosurgery, Xiangtan Central Hospital, Hunan Province 411100,China
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摘要 目的】探讨吲哚菁绿荧光血管造影在开颅显微手术治疗前循环动脉瘤中的应用价值。【方法】回顾性分析湘潭市中心医院神经外科2017年3月至2019年3月应用荧光血管辅助显微手术夹闭的90例前循环动脉瘤患者的临床资料。所有手术患者术后3 d内行头部CTA或脑血管DSA评估动脉瘤夹闭效果;术后3个月采用GOS评分评估患者预后。【结果】6例患者初次夹闭后有载瘤动脉狭窄,通过更换合适的动脉瘤夹或调整动脉瘤夹位置后再次荧光造影显示载瘤动脉通畅;4例患者发现有动脉瘤瘤颈残留,此4例患者2例增加了一个动脉瘤夹,另2例及时调整动脉瘤夹的位置,最终将动脉瘤完全夹闭。9例患者穿支血管误夹,造影后通过调整动脉瘤夹的位置避免了误夹。术后复查结果显示90例患者均无载瘤动脉狭窄、瘤颈残留和穿支血管损伤。手术后3个月进行随访,对所有患者进行GOS评分判断预后,其中GOS评分为4分、5分共68例,即轻度残疾但可独立生活或恢复正常生活属于恢复优良,本研究患者恢复优良率为75.6%(68/90)。【结论】吲哚菁绿荧光血管造影辅助前循环动脉瘤夹闭术可以有效减少术后载瘤动脉狭窄、动脉瘤颈残留、穿支血管损伤等并发症的发生,可较好地改善患者生存质量,具有较高的临床应用价值。
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关键词 颅内动脉瘤/外科学荧光素血管造影术神经外科手术    
Abstract:【Objective】To investigate the value of indocyanine green angiography in the treatment of anterior circulation aneurysms by craniotomy. 【Methods】From March 2017 to March 2019, 90 cases of anterior circulation aneurysms were clipped by fluorescence-assisted microsurgery in neurosurgery department of Xiangtan Central Hospital. The clipping effect of aneurysms was evaluated by head CTA or DSA within 3 days after operation, and the prognosis was evaluated by GOS score three months after operation. 【Results】Six patients had parent artery stenosis after the first clipping. After changing the appropriate aneurysm clip or adjusting the position of the aneurysm clip, fluorescence angiography showed that the parent artery was unobstructed; 4 patients found residual aneurysm neck, 2 of these 4 patients added an aneurysm clip, and the other 2 timely adjusted the position of the aneurysm clip, and finally completely clipped the aneurysm. In 9 patients, the perforating vessels were mistakenly clipped. After angiography, the location of the aneurysm clip was adjusted to avoid the false clipping. The results of postoperative reexamination showed that there were no parent artery stenosis, residual tumor neck and perforating vessel injury in 90 patients. After 3 months of follow-up, all patients were evaluated by gos score. The GOS score was 4 points and 5 points in 68 cases, that is, mild disability but can live independently or return to normal life belongs to good recovery. The excellent and good rate of patients in this study was 75.6% (68/90). 【Conclusion】Indocyanine green fluorescence angiography assisted anterior circulation aneurysm clipping can effectively reduce the incidence of complications such as parent artery stenosis, residual aneurysm neck, perforating vessel injury, etc., and can improve the quality of life of patients, which has high clinical application value.
Key wordsIntracranial Aneurysm/SU    Fluorescein Angiography    Neurosurgical Procedures
收稿日期: 2019-09-09     
PACS:  R651.122  
引用本文:   
曾群, 江辉, 徐凡, 姜维民, 罗可. 荧光血管造影辅助前循环动脉瘤夹闭术治疗前循环动脉瘤的疗效分析[J]. 医学临床研究, 2020, 37(11): 1708-1710.
ZENG Qun, JIANG Hui, XU Fan, et al. Clinical Analysis of Anterior Circulation Aneurysm Clipping Assisted by Fluorescein Angiography in the Treatment of Anterior Circulation Aneurysm. JOURNAL OF CLINICAL RESEARCH, 2020, 37(11): 1708-1710.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.11.033     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I11/1708
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