颅内动脉瘤的显微手术治疗体会

目的探讨颅内动脉瘤的诊断、手术时机和显微手术方法。方法回顾性分析我院2005年9月至2009年7月收治的65例颅内动脉瘤患者经显微外科治疗的临床资料。结果65例患者共76个动脉瘤中：70个行瘤颈夹闭术、4个行动脉瘤包裹术、2个术中动脉瘤破裂。出院时按格拉斯哥结局量表（GOS）评定手术疗效：58例恢复良好、3例中度病残、2例重度病残、1例植物生存、1例死亡。结论CT、MRI、计算机体层摄影血管成像（CTA）和数字减影血管造影（DSA）可为颅内动脉瘤的诊断提供重要的信息。显微手术夹闭是颅内动脉瘤的一种成熟、可靠和有效的治疗方法。早期手术能减少再出血，降低病死率和致残率。

Microsurgerical treatment of intracranial aneurysms in 65 cases

Objective To explore the diagnostic procedure, operative time and microsurgical technique in the patients with intracranial aneurysm Methods The clinical data of 65 intracranial aneurysms patients underwent microsurgery in our hospital from September 2005 and July 2009 were analyzed retrospectively. Results There were 76 intracranial aneurysms in 56 patients, including 70 cases of clipped aneurysms, 4 cases were wrapped aneurysms and 2 cases were ruptured aneurysms. According to GOS, of 65 patients with intracranial aneurysms, 58 patients were recovered well, 3 patients were moderately disabled, 2 patients were severely disabled, 1 patient vegetatively survived and 1 died after the surgery. Conclusions CT, magnetic resonance angiography, CT angiography and Digital subtraction angiography can provide important information for diagnosis of intracranial aneurysms. Microsurgi-cal clipping of intracranial aneurysms still is a reliable and effective method. Early microsurgery for ruptured in-tracranial aneurysms can decrease rebleeding, disabled rate and mortality.