可脱球囊血管内介入治疗外伤性颈内动脉海绵窦瘘体会.docVIP

可脱球囊血管内介入治疗外伤性颈内动脉海绵窦瘘体会 　　[摘要] 目的 探讨可脱球囊治疗外伤性颈内动脉海绵窦瘘的治疗效果。 方法 回顾性分析2009年1月～2017年4月中国医科大学附属第四医院神经外科收治的外伤性颈内动脉海绵窦瘘患者33例，采用可脱球囊治疗外伤性颈内动脉海绵窦瘘患者，其中单球囊栓塞26例，多球囊栓塞7例，观察瘘口封堵情况及术后的并发症发生情况。结果 患者颅内杂音、突眼、颅神经麻痹等临床症状均得到改善；2例（6%）发生术后24 h内球囊破裂，再次球囊栓塞后完全封堵；1例（3%）并发外展神经损伤，术后3个月回访好转。 结论 可脱球囊治疗外伤性颈内动脉海绵窦瘘安全可靠。 　　[关键词] 可脱球囊；外伤性颈内动脉海绵窦瘘；血管栓塞治疗；介入治疗 　　[中图分类号] R651.1 [文献标识码] B [文章编号] 16737-9701（2018）03-0077-03 　　The experience and inspiration of intravascular interventional therapy of detachable balloon for traumatic carotid-cavernous fistula 　　GAO Fei 　　Second Department of Neurology， Central Hospital Affiliated to Shenyang Medical College， Shenyang 110024， China 　　[Abstract] Objective To investigate the effect of intravascular interventional therapy of detachable balloon for traumatic carotid-cavernous fistula. Methods 33 cases with traumatic carotid-cavernous fistula at the Department of Neurosurgery in the Fourth Affiliated Hospital of China Medical University from January 2009 to April 2017 were retrospectively reviewed. The patients were received intravascular interventional therapy of detachable balloon for traumatic carotid-cavernous fistula. Among the patients， 26 cases were single ball embolism， 7 cases were multi balloon embolism. During the treatment， observation of fistula closure and postoperative complications were carried out. Results Patients with intracranial murmur， exophthalmos， cranial nerve paralysis and other clinical symptoms had been improved； in two cases（6%）， the balloon ruptured within 24 hours after operation， and completely blocked after balloon embolism again. One case（3%） supervened abducent nerve injury while improving after three months of the operation. Conclusion Detachable balloon treatment of traumatic carotid cavernous fistula is safe and reliable. 　　[Key words] Detachable balloon； Traumatic carotid cavernous fistula； Vascular embolization； Interventional therapy 　　?i内动脉海绵窦瘘（carotid cavernous fistula，CCF）是在海绵窦段的颈内动脉或分支断裂造成的，常见原因是颅骨骨折碎片或微小动