颅内多发动脉瘤的手术治疗

目的报告29例颅内多发动脉瘤，探讨其手术时机、手术方法及影响手术疗效的相关因素。方法手术治疗颅内多发动脉瘤29例，共73个动脉瘤，一期手术17例，二期手术12例。动脉瘤直接夹闭62个，动脉瘤包裹3个，动脉瘤孤立1个，7个未破裂动脉瘤未予手术处理。结果术后恢复良好24例，差4例，死亡1例。结论正确判断多发动脉瘤中的破裂动脉瘤并首先进行处理；根据动脉瘤的部位、Hunt-Hess临床分级等因素，一期或二期处理多发动脉瘤，以期达到最佳的治疗效果。

Surgical treatment of multiple intracranial aneurysms

Objective To study their surgical timing and strategy as well as relative factors with the surgical outcome through 29 cases of multiple intracranial aneuryms(MIA).Methods Twenty-nine patients with MIA had 73 aneurysms.One-stage operations were taken in 17 cases,two-stage in 12cases.Sixty-two aneurysms were clipped directly,three wrapped and one trapped.Seven unruptureed aneurysms were not operated in 4cases.Results surgical outcome were good in 24cases,poor in 4 cases,and one dead.Conclusions The ruptured aneurysms in MIA should be identified firstly and clipped in early stage.Based on the sites of aneurysms and patient's condition,all aneurysms should be treated selectively in either one or two stages,in order to get better outcome.