显微外科手术治疗颅内多发动脉瘤22例临床分析

目的探讨颅内多发动脉瘤的显微外科手术时机、方法及影响手术效果的相关因素。方法回顾分析22例54个颅内多发动脉瘤行显微外科手术治疗的临床资料。采取早期与择期、一期与分期相结合的方法处理多发动脉瘤,原则是先处理破裂动脉瘤,再处理未破裂动脉瘤。结果 22例54个颅内多发动脉瘤直接夹闭48个,包裹3个,未处理3个。依据格拉斯哥结果评分判断预后：优良16例,轻残3例,重残2例,死亡1例。结论显微外科手术治疗颅内多发动脉瘤效果显著,正确判断责任动脉瘤并予首先处理,根据动脉瘤部位、Hunt-Hess临床分级及患者自身状况等选择一期或分期手术可达到良好治疗效果。

Clinical Study on 22 Cases of Multiple Intracranial Aneurysms after Microsurgical Treatment

Objective To study the surgical timing and strategy as well as relative factors of multiple intracranial aneurysms with the surgical outcome. Methods The clinical data of 22 cases with 54 aneurysms after micrsurgieal operation were analysed retrospectively. The Multiple Intracranial Aneurysms （MIA） were treated by the method of combining early-stage with selective stage operations and one-stage with two-stage operations. The operatings followed the principle that the ruptureed aneurysm was dealt with first and then the unruptureed aneurysm. Results Forty-eight aneurysms were clipped directly, three aneurysms were wrapped and three aneurysms was not treat. The GOS scores showed that the surgical outcomes were good in 16 cases, light disability in 3 cases, severe disability in 2 cases and 1 death case. Conclusion The surgical outcomes are predominant if MIA undergo microsurgical operation. It is important to determine the responsibili- ty aneurism and clip it first and choose one-stage operation or two-stage operation according to Hunt-Hess clinical stage, the sites of aneurysm and the patient＇s condition in order to achieve good treatment outcome.