颅内动脉瘤治疗方案选择的临床研究

目的探讨显微手术与血管内栓塞治疗颅内动脉瘤的效果、特点、适应证及治疗原则。方法回顾性分析应用显微手术治疗的202例颅内动脉瘤患者与经血管内介入治疗的56例颅内动脉瘤患者的临床资料。结果术后按GOS评分评定手术疗效,经显微手术治疗的202例中,术后恢复良好132例,中残38例,重残21例,死亡11例。经血管内介入治疗的56例61个动脉瘤中,54个动脉瘤行可脱性弹簧圈栓塞,1个行单纯支架置入,6个行支架置入+可脱性弹簧圈栓塞;术后恢复良好35例,中残11例,重残8例,死亡2例。结论显微手术与血管内栓塞治疗颅内动脉瘤各有其特点及适应证。根据动脉瘤的大小、部位、术者经验选择不同的手术方式,均能取得满意效果。

Treatment of intracranial aneurysms by craniotomy or endovascular embolization

Objective To explore the characteristics, indications and principle of treatment of intracranial aneurysms by endovascular embolization and craniotomy, and the curative effects of endovascular embolization and craniotomy on them. Methods Of 258 patients with intracranial aneurysms, 202 were treated by microsurgery and 56 by endovascular embolization. The clinical data of all the patients were analyzed retrospectively. Results According to GOS, of 202 patients undergoing microsurgery, 132 were recovered well, 38 moderately disabled, 21 severely disabled and 11 dead, and of 56 patients undergoing endovascular embolization, 35 were recovered well, 11 moderately disabled, 8 severely disabled and 2 died. Conclusions Each of both the microsurgery and endovascular embolization for the intracranial aneurysms have itself characteristics and indication. They can be not substituted for each other. The method suitable to treating intracranial aneurysms should be selected according to the characteristics of the aneurysm and experiences of the operator.