一期手术治疗颅内多发动脉瘤

目的 探讨颅内多发动脉瘤的治疗方法和各种方法之间的利与弊。方法 经一期手术治疗颅内多发性动脉瘤25例，其中，男8例，女17例，最大年龄73岁，最小29岁，平均54．2岁。25例中查出动脉瘤56个，其中颈内-后交通动脉瘤17个，大脑中动脉瘤23个，前交通动脉瘤4个，颈内-脉络膜前动脉瘤6个，颈内动脉分叉部动脉瘤2个，颈内-眼动脉段动脉瘤2个，大脑前动脉远端动脉瘤2个。根据形态特点囊性动脉瘤51个，梭形动脉瘤5个。25例均行翼点入路，单侧开颅6例，双侧开颅19例；夹闭动脉瘤51个，包裹5个。结果 25例手术全部成功，存活率100％，经半年的随访，仍有2例偏瘫，1例植物生存。3例动眼神经瘫尚在恢复中，6例脑积水中，有4例手术后脑室缩小，2例无明显变化。结论 如果患者全身状态允许及动脉瘤的位置和性状合适，一期手术治疗颅内多发性动脉瘤是安全和可行的，效果是良好的。

Single-stage surgical treatment of multiple intracranial aneurysms

Objective To explore the treatment of the patients with multiple intracranial aneurysms. Methods 25 patients with multiple intracranial aneurysms were treated by single-stage operation.Among of 25 these patients, there were 56 aneurysms. 17 aneurysms were located in the posterior communicating artery, 23 in the middle cerebral artery, 6 in the anterior communicating artery and anterior cerebral artery, 6 in Ic-Ach, 2 in Ic-Bif, 2 in Ic-Oph. 6 patients were operated by unilateral cranio tomy and 19 patients were operated by bilateral cranio tomy 51 aneurysms were clipped and 5 aneurysms were wrapped. Results The rate of success in the operation is 100%, 25 patients have been followed up for 6 months, there was limb paralysis of one side in 2 patients, vegetatcve statu in 1 patient. Conclusions If the preoperative condition of patients surgery is good, single-stage for multiple intracranial aneurysms is safety and the outcome can be good.