Tam sim no, txoj hauv kev zoo los kho ruptured intracranial aneurysms yog intravascular intervention. Kev siv cov coil embolization tuaj yeem txo qhov cuam tshuam ntawm cov ntshav ntws ntawm cov hlab ntsha aneurysm, ua rau cov hlab ntsha tawg tuaj yeem tsim cov thrombus, yog li kho tus kab mob. Nrog rau kev txhim kho cov cuab yeej kho mob, stent-pab coil embolization tau txais kev saib xyuas dav dav. Kev txhawb nqa stent muaj kev txhawb nqa rau kev txhim kho hemodynamics ntawm aneurysms.
Cov ntsiab lus tseem ceeb ntawm stent-pab coil embolization yog ua txhua yam kev phais hauv cov hlab ntsha. Thaum lub sijhawm ua haujlwm phais, kev cuam tshuam ntawm cov yam ntxwv xws li hydrocephalus thiab nce intracranial siab tuaj yeem zam tau. Nws tsis tshua muaj kev puas tsuaj thiab tuaj yeem tiv thaiv cov khoom siv los ntawm kev txhawb nqa cov hlab ntsha thiab cov ntaub so ntswg nyob ib ncig ntawm intracranial aneurysm, uas yuav ua rau muaj kev puas tsuaj rau qhov hnyav. Nws pab txhim kho cov kev kho mob ntawm cov neeg mob nrog ruptured intracranial aneurysms.
Cov kws tshawb fawb tau pom tias vim intracranial aneurysms loj hlob sai thiab subarachnoid hemorrhage yog ib qho tseem ceeb cuam tshuam rau tus mob ntawm aneurysms, lub sij hawm mob ntev yuav ua rau muaj kev pheej hmoo ntawm cov teeb meem mob thrombotic, yog li ua rau kev puas tsuaj rau tus neeg mob lub paj hlwb. Yog li, cov teebmeem ntawm stent-pab coil embolization ntawm intracranial ruptured aneurysms ntawm lub sijhawm phais sib txawv yog txawv:
1. Hauv 24 teev ntawm qhov pib
Txij li thaum qib ntawm cerebral vasospasm yog qhov mob me me nyob rau theem pib ntawm intracranial aneurysm, microcatheter tuaj yeem ua tau zoo xa mus rau qhov chaw aneurysm los ntawm stent-pab coil embolization, thiab kev cuam tshuam ntawm cov txheej txheem no kuj me me. Stent-pab coil embolization nyob rau hauv 24 teev ntawm qhov pib tuaj yeem txhim kho cov nyhuv kaw qhov aneurysm thiab txo qhov kev puas tsuaj rau lub paj hlwb los ntawm kev kho thaum ntxov; Nyob rau tib lub sijhawm, stent-pab coil embolization kev kho mob rau cov neeg mob kom sai li sai tau tuaj yeem txo cov ntshav mus rau qhov aneurysm, txhawb kev txo qis ntawm qhov ntim, pab kom tshem tawm cov ntaub so ntswg sai, txo qhov mob hnyav thiab qhov degree ntawm cov ntaub so ntswg puas hlwb, thiab ces txo lub cev inflammatory teb.
2. Tsis pub dhau 24 mus rau 72 teev ntawm qhov pib
Txij li lub sij hawm ntawm kev phais tshaj 24 teev, lub sij hawm kho mob kuj lig. Cov neeg mob ruptured intracranial aneurysms yuav muaj vascular txhab thiab intracranial vascular puas tsuaj, uas yuav cuam tshuam rau lawv cov hemodynamics, txo tus nqi ntawm tag nrho interventional embolization, thiab ces ua rau muaj kev puas tsuaj ntau dua rau lub paj hlwb kev ua haujlwm ntawm cov neeg mob aneurysms. Nyob rau tib lub sijhawm, yog tias kev kho mob phais tau ua nyob rau hauv 24 mus rau 72 teev, lub sijhawm pib tshwm sim kuj ntev, cov lus teb inflammatory hauv tus neeg mob lub cev yuav khaus ntau dua, thiab qib kev txhawb nqa rau tus neeg mob lub cev yuav ntau dua, ua kev kho mob nyuaj dua thiab kev kho mob tsis zoo.
Nyob rau hauv cov ntsiab lus, stent-pab coil intracranial embolization yog ib qho kev kho mob zoo rau intracranial ruptured aneurysms, tuaj yeem txo qhov tshwm sim ntawm intraoperative los ntshav, txhim kho tus neeg mob lub paj hlwb muaj nuj nqi, thiab tiv thaiv ntau dhau inflammatory teb. Txawm li cas los xij, ntau lub sijhawm phais yuav cuam tshuam rau tus neeg mob lub paj hlwb puas thiab cov lus teb inflammatory thaum thiab tom qab ua haujlwm. Piv nrog rau kev phais hauv 24 mus rau 72 teev, kev phais hauv 24 teev yuav ua rau muaj kev puas tsuaj rau cov neeg mob tsawg dua, thiab tus neeg mob cov lus teb inflammatory yuav txo tau raws li.