颅内多发动脉瘤的显微手术治疗

目的 探讨颅内多发动脉瘤(MIA)的手术时机、手术方法及影响手术效果的相关因素.方法 回顾分析18例44个MIA显微手术治疗的临床资料.采取早期与择期、一期与分期相结合的方法处理MIA,原则是先处理破裂动脉瘤,再处理未破裂动脉瘤.结果 动脉瘤直接夹闭39个,包裹2个,未处理3个.GOS评判:优良13例,轻残3例,重残1例,死亡1例.结论 显微手术治疗MIA,应正确判断责任动脉瘤并首先处理,根据动脉瘤的部位、Hunt-Hess分级及临床症状,选择正确的手术时机和手术方案,可达到良好效果.

Microsurgical treatment of multiple intracranial aneurysms

Objective To study the surgical timing and strategy as well as relative factors with surgical outcome through 18 cases of multiple intracranial aneurysms (MIA). Methods The clinical datas of 18 cases with 44 aneurysms who underwent microsurgical operation were analyzed retrospectively. The MIA were treated through the method of combining early - stage with select - stage operation and one - stage with two - stage operation. The operating principle was that the ruptured aneurysm was performd operation at first. Results Thirty -nine aneurysms were clipped directly, two aneurysms were wrapped and three aneurysms without any treatment. The surgical outcome was good in 13 cases, light disability in 3 cases,severe disability in 1 case and death in 1 case. Conclusion Determination of the responsibility aneurysm,clipping the responsibility aneurysm firstly, choise of one -stage operation or two- stage operation according to the sites of aneurysms and the patients condition should be considered to get good outcome.