颅内复杂动脉瘤的手术治疗

目的回顾总结近5年经手术治疗的47例复杂颅内动脉瘤的处理经验和教训,以进一步提高疗效。方法47例中37例行显微手术夹闭瘤颈,5例行颅内外动脉搭桥术及动脉瘤孤立术,2例行动脉瘤切除载瘤动脉缝合术,2例行动脉瘤切除后近远端载瘤动脉端端吻合术,动脉瘤包裹1例。结果按GOS评分,预后良好35例,中度残疾6例,严重伤残2例,死亡4例。结论颅内复杂动脉瘤的治疗仍是显微神经外科方面的难题,应根据不同的病例,选用多种治疗方案。

Microsurgery for Complex Intracranial Aneurysms

Objective To analyse the experience and lesson of microsurgery for the complex intracranial aneurysms in rent five years. Methods Of 47 patients with complex intracranial aneurysms, 37 were treated by microsurgically clipping the aneurysmal necks, 5 by aneurysms trapping followed extracranial and intracranial arteries bypass, 4 by reconstructing the parent arteries followed resection of the aneurysms and 1 by coating the aneurysm. Results The prognoses of all the patients were evaluated by Glasgow outcome scale (GOS). Of 47 patients, 35 were recovered well, 6 moderately disabled, 2 several disabled and 4 died. Conclusions The treatment of complex aneurysms is still a challenge to microneurosurgery. The proper method should be selected for individual case.