摘要
目的 探讨颅内多发动脉瘤的手术策略并分析临床疗效.方法 回顾性分析2009年1月至2013年12月手术治疗49例颅内多发动脉瘤患者的临床资料.49例患者中,男性12例,女性37例;平均年龄（49±11）岁;35例动脉瘤破裂,14例未破裂;治疗策略有一期手术（一侧入路夹闭所有动脉瘤）,二期治疗（分期处理所有动脉瘤）和部分治疗（只处理责任动脉瘤）.随访中复查脑CT血管造影（CTA）或数字减影血管造影（DSA）,用格拉斯哥预后量表（GOS）评估预后.结果 一期手术32例（65.3％）,二期治疗9例（18.4％）,部分治疗8例（16.3％）.47例随访4 ～ 49个月,平均（22 ±7）个月.术后CTA或DSA均未见动脉瘤复发.根据GOS评分,患者预后良好（4～5分）41例（83.7％）,残疾（2～3分）6例（12.2％）,死亡（1分）2例（4.1％）.结论 在具有娴熟手术技术的前提下选择合适的患者,根据动脉瘤和患者的特征制定个性化的手术策略,能提高颅内多发动脉瘤的手术疗效.
Objective To discuss the surgical strategies and analyze the clinical outcomes of multiple intracranial aneurysms （MIA）.Methods The clinical data of 49 MIA patients surgically treated between January 2009 and December 2013 was analyzed retrospectively.Among the 49 patients,12 patients were male and 37 were female,mean age（49 ± 11）years.Thirty-five patients had ruptured aneurysms,and 14 had unruptured aneurysms.Treatment strategies included one-stage operation （MIA were treated in one-stage with an unilateral approach）,two-stage treatment （MIA were treated stage by stage） and partial treatment （only ruptured aneurysm was treated）.Postoperative CT angiograms （CTA） or digital subtraction angiograms （DSA） were reviewed and the Glasgow Outcome Scale （GOS） scores were evaluated during follow-up period.Results Thirty-two patients （65.3%） underwent one-stage operation,9 patients （18.4%） underwent two-stage treatment,and 8 patients （16.3%） underwent partial treatment.Forty-seven patients were followed up 4-49 months,mean （22 ± 7） months.Postoperative CTA or DSA showed no aneurysm recurrence.According to the GOS scores,41 patients （83.7%） with good outcomes （GOS 4,5）,6 patients （12.2%） were disabled （GOS 2,3） and 2 patients （4.1%） were dead （GOS 1）.Conclusion Selecting the right patients for surgery and making personalized surgical strategies based on the characteristics of patients and aneurysms could improve the surgical outcomes of MIA.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2015年第2期145-149,共5页
Chinese Journal of Surgery
关键词
颅内动脉瘤
显微外科手术
治疗效果
Intracranial aneurysms
Microsurgery
Treatment outcome
