颅内动脉瘤破裂的早期综合治疗

目的:探讨颅内动脉瘤破裂早期行显微手术治疗与血管内栓塞治疗的效果。方法:250例颅内动脉瘤破裂在3 d内早期经显微手术或血管内栓塞治疗,其中115例显微手术,135例经血管内栓塞。随访3~30个月。术前术后均行TCD监测。结果:显微手术115例,院内死亡5例,半年后优78例,良27例,差3例,植物生存1例,死亡1例,总死亡率5.22%。135例血管内治疗,院内死亡5例。半年后,栓塞组优95例,良30例,差4例,死亡1例,总死亡率4.44%。结论:要重视颅内动脉瘤破裂的早期临床综合治疗,其中显微手术与血管内栓塞治疗各有所长,还不能相互取代。有些病例需二者结合效果更好。

Early clinical combined therapy of ruptured intracranial aneurysm

Objective:To analyze the curative effect of early microsurgical and endovascular embolization treatment on the ruptured intracranial aneurysms.Methods:Of 250 ruptured intracranial aneurysms 115 were treated by microsurgery and 135 by endovascular embolotherapy.Results:In 115 patients receiving microsurgery,5 patients died in hospital,after 6 months,Satisfactory recovery was obtained in 78 patients,favourable in 27 and poor in 3,persistent vegetative in 1 and 1 died,deaths total rate is 5.22%.In 135 patients receiving endovascular embolization,5 patients died in hospital.after 6 months,Satisfactory recovery was obtained in 95 patients,favourable in 30 and poor in 4,1 patients died,deaths total rate is 4.44%.Conclusion:To ask for reconstruction early clinical combined therapy of ruptured intracranial aneurysm.Both microsurgery and endovascular embolotherapy have its merits,and don't replace each other.Some cases may attain better result by using two technique together.