腺苷诱导心脏停搏及低血压辅助颅内动脉瘤夹闭的研究进展Advances in Adenosine-Induced Cardiac Arrest and Hypotension-Assisted Intracranial Aneurysm Clipping

• Published in: Zhongguo cuzhong zazhi Vol. 20; no. 6; pp. 790 - 796
• Main Author: 刘长通,童贺,宋国红(LIU Changtong, TONG He, SONG Guohong)
• Format: Journal Article
• Language: Chinese
• Published: Editorial Department of Chinese Journal of Stroke 01.06.2025
• Subjects: adenosine; intracranial aneurysm; microsurgery; 显微外科手术; 腺苷; 颅内动脉瘤
• ISSN: 1673-5765
• DOI: 10.3969/j.issn.1673-5765.2025.06.016

尽管介入手术是颅内动脉瘤的首选治疗方式，但对复杂动脉瘤，显微外科手术仍不可或缺。安全夹闭动脉瘤并保持载瘤动脉及其分支通畅，是手术的关键与难点。腺苷诱导的短暂心脏停搏及低血压可迅速减少动脉瘤血流，优化解剖条件，提高夹闭的安全性与有效性。相比传统方法，腺苷操作更简便、无创，且起效更快、代谢清除更快、不良反应更少，在颅内动脉瘤夹闭手术中具有应用潜力。然而，其个体化剂量调控及潜在心血管风险仍需进一步研究。本文综述了腺苷在颅内动脉瘤显微外科手术中的作用机制、优缺点、适应证、禁忌证、给药方式及安全性，以期为临床应用提供更全面的参考。Abstract: Although interventional surgery is the preferred treatment for intracranial aneurysms, microsurgery remains indispensable for complex aneurysms. The key challenge in surgery is to achieve safe aneurysm clipping while maintaining patency of the parent artery and its branches. Adenosine-induced transient cardiac arrest and hypotension can rapidly reduce aneurysmal blood flow, optimize anatomical conditions, and enhance the safety and efficacy of clipping. Compared to traditional methods, adenosine administration is simpler, non-invasive, fast-acting, rapidly metabolized, and associated with fewer adverse reactions, showing potential application in intracranial aneurysm clipping. However, individualized dose regulation and potential cardiovascu