血管内栓塞和显微神经外科夹闭手术治疗颅内破裂动脉瘤

目的探讨早期经血管内栓塞和显微神经外科手术治疗颅内破裂动脉瘤的有效性。方法240例颅内破裂动脉瘤患者，110例在发病后3天内行早期手术治疗，其中选择经血管内栓塞治疗70例，开颅显微神经外科夹闭手术治疗40例。结果110例颅内破裂动脉瘤早期经血管内栓塞治疗70例，完全栓塞59例（84．29％）；近全栓塞11例（15．71％），即栓塞率≥85％；治疗后3—6月内随访，56例（80％）完全恢复健康，9例轻度神经功能障碍，5例术后病情恶化，重度神经功能障碍。显微外科手术夹闭40例，完全夹闭36例（90％），不全夹闭或包裹治疗4例（10％），术后3—6月随访示：临床治愈34例（85％），4例轻度神经功能障碍，1例重度偏瘫、语言障碍，1例死亡。结论颅内破裂动脉瘤的早期手术治疗可有效防止动脉瘤再破裂出血和迟发性脑血管痉挛危险因素的发生，可降低其病残率和死亡率。

Discussion on the factors affecting ruptured intracranial aneurysms early treated by microsurgical clipping and endovascular coiling

Objective To discuss the therapeutic effect of ruptured intracranial aneurysms early treated by microsurgical clipping and endovascular coiling.Methods Of 240 ruptured intracranial aneurysms 110 were early treated by microsurgical clipping and endovascular coiling.Result A total of 40 patients had microsurgical clipping and 70 had endovascular coiling.At 3-6 months,80% of patients recovered with no complication in the coiling groups,9 patients had mild disability,and 5 patients became aggravated.In the clip...