Intracranial aneurysms yog qhov ua rau tuag taus ntawm cov hlab ntsha, thiab lawv qhov tawg tuaj yeem ua rau subarachnoid hemorrhage, ua rau tus neeg mob lub neej hnyav. Aneurysm embolization siv lub catheter xa cov ntaub ntawv embolic mus rau hauv qhov aneurysm los ntawm txoj kev intravascular, cais nws los ntawm cov ntshav ntws thiab ua tiav lub hom phiaj kho. Txawm li cas los xij, txoj kev kho mob me me no tsis yog tsis muaj kev pheej hmoo. Intraoperative thiab postoperative teeb meem, xws li thrombosis, tsiv ntawm lub coil, thiab aneurysm rupture thiab los ntshav, tej zaum yuav muaj kev phiv rau tus neeg mob qhov kev tshwm sim. Kab lus no qhia koj yuav ua li cas tiv thaiv qee qhov teeb meem tshwm sim thiab yuav ua li cas nrog cov teeb meem thaum lawv tshwm sim.
1. Intraoperative thrombotic txheej xwm
Yuav tiv thaiv li cas?
Ua ntej, heparinization yuav tsum tau siv tag nrho. Yog tias stent implantation tau ua tiav, kev kho antiplatelet txaus yuav tsum tau ua ua ntej / thaum lub sijhawm ua haujlwm. Secondly, the coaxial system should be continuously infused to prevent the guiding catheter or intermediate catheter from continuously pushing against one side of the blood vessel, causing endothelial damage and thrombosis. Thaum lub coil protrudes, ib tug kho stent yuav tsum tau implanted yog tias tsim nyog. Thaum lub sijhawm ua haujlwm, lub stent yuav tsum qhib thiab txuas zoo rau ntawm phab ntsa, thiab kev ua haujlwm yuav tsum maj mam txo qis dua lossis ua haujlwm tsis zoo thiab zam kev puas tsuaj ntawm endothelial.
Yuav ua li cas nrog nws?
Yog tias thrombosis tshwm sim thaum lub sijhawm ua haujlwm, lub thrombus load me me los yog lub thrombus nyob rau hauv lub distal ceg, tirofiban los yog urokinase yuav infused intra-arterially los yog intravenously. Thaum lub thrombus load loj los yog cov hlab ntsha loj yog occluded, intravascular mechanical thrombectomy tuaj yeem sim.
2. Aneurysm rupture thaum phais
Yuav tiv thaiv li cas?
Ua ntej, lub microcatheter yuav tsum tau ua kom zoo zoo kom txo tau cov kev khiav hauj lwm ntawm cov guidewire nyob rau hauv lub aneurysm kab noj hniav thiab xyuas kom meej lub adjustability ntawm microcatheter thaum lub sij hawm coil embolization txheej txheem. Thaum ntim cov coil, qhov loj thiab hardness yuav tsum tsim nyog kom tsis txhob ntim ntau dhau. Yog tias muaj qhov pom tseeb tsis zoo thaum lub sijhawm ntim khoom, tsis txhob yuam cov ntim khoom, thiab tshem tawm lub microcatheter yog tias tsim nyog. Nyob rau tib lub sijhawm, xyuam xim rau qhov cuam tshuam ntawm stent tso tawm ntawm txoj hauj lwm ntawm microcatheter thiab ua kom raws sijhawm.
Yuav ua li cas nrog nws?
Thaum muaj kev sib tsoo tshwm sim, protamine tuaj yeem siv los ua kom tsis muaj zog heparin tam sim ntawd thiab ua kom nrawm nrawm ntawm cov pob txha. Yog tias txoj haujlwm ntawm microcatheter tsis zoo tagnrho, lossis nws raug txiav txim siab tias cov ntshav nyob ntawm lub caj dab ntawm qhov aneurysm, nws yog qhov zoo tshaj rau kev koom tes nrog kev thaiv ib ntus, suav nrog kev thaiv lub zais pa ib ntus, coil blockage, compression ntawm cov hlab ntsha carotid, thiab lwm yam. .
3. Caij nplooj ntoos hlav coil hloov chaw
Yuav tiv thaiv li cas?
Yog hais tias qhov dav-caj dab aneurysm yog embolized nrog ib tug yooj yim kauj, ib tug me ntsis loj txoj kab uas hla pob tawb kauj tuaj yeem xaiv. Rau qhov dav-caj dab aneurysms, stent-pab embolization tuaj yeem xaiv ntau li ntau tau. Rau me me aneurysms, stent-pab embolization nrog mesh mesh muaj kev nyab xeeb dua.
Yuav ua li cas nrog nws?
Yog hais tias qhov kev hloov ntawm lub kauj tshwm sim ua ntej lub kauj tawm, lub kauj yog thawj zaug rov qab los yog lub zais pa lossis stent-pab thev naus laus zis yog siv los txuas ntxiv cov embolization; Yog hais tias ib nrab protrusion, txav los yog untwisting ntawm lub kauj tshwm sim tom qab lub coil raug tso tawm, yog hais tias lub kauj tsis muaj pom tseeb pulsation thiab tsis cuam tshuam rau cov ntshav khiav, yuav tsum tsis muaj kev kho tshwj xeeb, thiab cov tshuaj antiplatelet aggregation yuav muab raws li qhov tsim nyog. Thaum lub coil tsiv los yog untwisted cuam tshuam rau cov ntshav khiav, lub kauj tuaj yeem raug tshem tawm nrog kev pab los ntawm thrombectomy stent; Yog tias lub coil tsis tuaj yeem raug tshem tawm, lub stent tuaj yeem muab tso rau kom ruaj khov ntawm lub kauj hauv qhov aneurysm, thiab kev siv tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob tuaj yeem muab tom qab phais kom tiv thaiv ischemia.
Nyob rau hauv luv luv, kev kho mob ntawm aneurysms yuav tsum to taub tag nrho cov teeb meem ntawm lub aneurysm thiab cov niam txiv cov hlab ntsha, thiaj li yuav tsim ib tug tsim nyog txoj kev kho mob, xaiv cov ntaub ntawv tsim nyog, ua tib zoo thiab ceev faj thaum lub sij hawm ua hauj lwm, thiab siv cov txheej txheem tshuaj los txo qhov tshwm sim. ntawm teeb meem. Thaum muaj teeb meem tshwm sim, lawv yuav tsum tau teb rau thiab kho raws sijhawm thiab raug.