颅内动脉瘤的显微手术治疗

目的总结显微外科手术治疗颅内动脉瘤的方法和效果。方法回顾性分析我院302例经显微手术治疗的颅内动脉瘤患者的临床资料。结果302例手术患者中，有252例行瘤颈夹闭术，19例行夹闭后瘤体切除术，24例行包裹加固术，7例行孤立手术。术后根据GOS评分，治疗效果良好者258例（85．4％），效果不佳者25例（8．3％），死亡19例（6．3％）。结论颅内动脉瘤一旦诊断明确，应尽早手术以防其破裂出血。充分开放脑池和正确夹闭动脉瘤颈是手术成功的关键，积极预防脑血管痉挛可显著降低患者的致残率和死亡率。

Microsurgery for Intracranial Aneurysms(a Report of 302 Cases)

Objective To summarize the experience in treating intracranial aneurysms by microsurgery. Method The clinical data of 302 patients with intracranial aneurysms treated in our department from October, 1994 to May, 2006 were analysed retrospectively. Results Of 302 patients with intracranial aneurysms, 252 were treated by clipping aneurysmal necks, 19 by removing body after . clipping the aneurysmal necks, 24 by coating the aneurysm and 7 by trapping the aneurysm. There were good outcome in 258 patients （85.4%）, bad in 25 （8.3%） and 19（6.3%） died. Conclusions The operation should be performed as early as possible once the aneurysm is found. They are the key to the successful microsurgery to open cerebral cistern fully and to clip aneurysm neck correctly. The disabled and death rates may be decreased by positive prevention of cerebral vasospasm.