摘要
目的探讨颅内多发动脉瘤(MIA)的诊断以及手术时机和手术方法的选择。方法本组41例MIA中,经翼点开颅显微手术夹闭22例,其中一次性夹闭16例;行血管内栓塞19例,一次性栓塞9例。结果一次性手术夹闭的16例(32个)动脉瘤经DSA复查,29个夹闭完全,血管内栓塞的19例经DSA复查,3个动脉瘤栓塞不完全。行夹闭术的22例中,Hunt分级Ⅰ-Ⅲ级18例,Ⅳ级和Ⅴ级各2例,良14例,中残4例,重残2例,植物生存和死亡各1例;行栓塞术的19例中,Hunt分级Ⅰ-Ⅲ级17例,Ⅳ级2例,良13例,中残和重残各2例,植物生存和死亡各1例。结论CT为MIA破裂出血的诊断提供重要信息,DSA仍为MIA诊断的金标准,CTA和MRA是MIA诊断的良好补充。MIA一经诊断明确应尽早手术治疗,根据病人病情和经济状况酌情选择手术方法,但若系Hunt分级Ⅴ级者则只宜手术夹闭。
Objective To explore the diagnosis, the operative time and the techniques of multiple intracranial aneurysms （MIA）. Methods Of 41 patients with MIA, 22 were treated by microsurgically clipping the aneurysmal necks through pterion approach and 19 were treated by endocascular embolization. Results Of 22 patients undergoing microsurgery, whose conditions belonged in Hunt grade Ⅰ-Ⅲ in 18 patients, grade Ⅳ in 2 and grade Ⅴ in 2, 16 underwent surgery only once （clipping 32 aneurysms） and 6 twice. According to GOS, of 22 patients undergoing the surgery, 14 were recovered well,4 modertely disabled, 6 severely disabled, 1 vegetably survived and 1 died. Of 19 patients with 38 aneurysms undergoing endovascular embolization, whose conditions belonged in Hunt grades Ⅰ-Ⅲ in 17 patients and grade Ⅳ in 2, 13 were recovered well, 2 modertely disabled, 2 severely disabled, 1 vegetably survived and 1 died according to GOS. Conclusions Important information for MIA diagnosis is provided by CT and DSA is a gold standard to diagnose MIA. CTA and MRA is very helpful to the diegnosis of MIA. MIA should be operated as early as possible. According to the conditions and economic situations of the patient, the proper operative methods are selected.
出处
《中国临床神经外科杂志》
2006年第11期653-655,共3页
Chinese Journal of Clinical Neurosurgery
关键词
颅内多发动脉瘤
显微手术
血管内栓塞
诊断
Intracranial aneurysms
Microsurgery
Endovascular embolization
Diagnosis
