颅内动脉瘤的诊断和治疗方法探讨

目的：探讨颅内动脉瘤诊断，治疗方法和手术时机的选择，以提高手术疗效，减少残废率和病死率，方法：对410例颅内动脉瘤进行手术治疗，其中172例行直视手术夹闭，238例行血管内栓塞治疗，结果：疗效优298例，良852例，差12例，植物生存1例，死亡4例，结论：CT、MRI，MRA可为诊断颅内动脉瘤提供重要住处，多普勒（TCD）可作为无创性筛选，DSA是必不可少的决定性检查，直视显微手术夹闭术和血管内栓塞治疗是颅内动脉瘤的主要治疗方法，二者有机结合使颅内动脉瘤的治疗日趋完善，动脉瘤裂出血，主张早期或超早期手术。

Diagnosis and treatment of intracranial aneurysms

Objective To study the diagnostic procedures, surgicaltechniques, and operative time in the treatment of patients with intracranial aneurysms. Methods The data of 410 patients who had been operated upon for intracranial aneurysms were reviewed retrospectively. Among these patients, 172 received clipping under direct vision, and the remaining 238 were treated by endovascular embolization. Results Excellent results were seen in 298 patients, good (mild disabilities) in 85, and poor (moderate and serious disabilities) in 12. 14 patients survived in a vegetative state and 1 died. Conclusions CT, MRI and MRA provide important information for the diagnosis of intracranial aneurysms, but DSA is decisive. Aneurysm may be found by TCD. Microsurgical clipping under direct vision and endovascular embolization are the major therapeutic methods. Emergentcy microsurgery is applicable to patients with hemorrhage due to the rapture of intracranial aneurysm.