摘要
目的探讨颅内多发动脉瘤(M IA)的手术时机和手术方法的选择。方法本组76例M IA中,同时治疗责任和非责任动脉瘤52例。仅经翼点开颅显微手术夹闭34例,其中一次性夹闭32例,分次夹闭2例;行血管内栓塞,一次性栓塞11例;栓塞结合夹闭治疗7例。仅治疗责任病灶24例。结果手术夹闭的34例(68个)动脉瘤经DSA或CTA复查,63个夹闭完全,2个瘤颈残留,3个包裹。血管内栓塞的11例25个动脉瘤经DSA复查,22例栓塞完全,3个动脉瘤栓塞不完全。栓塞加夹闭的7例15个动脉瘤消失。结论M IA治疗应个体化分析,采用夹闭手术与血管内栓塞相结合,尽量一期治疗,从而降低治疗风险获得良好疗效。
Objective To explore the diagnosis, the operative time and the techniques of multiple intracranial aneurysms（MIA）. Methods The 52 of 76 MIA cases were treated on not only responsible but also non-responsible aneurysms. 34 cases were treated by microsurgery clipping on the aneurysmal necks, among them ,32 cases clipped once and 2 cases twice. 11 cases were treated by endovascular embolization. 7 eases were treated by endovascular embolization combine microsurgery clipping. Another 24 cases were only treated on the responsible aneurysms. Results Of 34 patients（68 aneurysms） undergoing microsurgery, followed-up by CTA or DSA, 63 aneurysms were clipped completely,2 had residued necks,3 were wrapped up. Of 11 patients （25 aneurysms） undergoing embolization,3 aneurysms were occluded incompletely. Of 7 patients（ 15 aneurysms）undergoing embolization combine clipping,all the 15 aneurysms disappeared. In curative effect, there was no statistic difference between embolization and clipping groups treated on one time. Among groups of once therapy,of twice therapy and of only treatment the responsible aneurysms, there were no statistic difference in curative effect. Conclusion trategy of the MIA should be analyzed respectively. With the best use of embolization and clipping, all aneurysms should be treated as far as possible in once, in order to reduce the risk of therapy and increase curative effect.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2009年第1期74-76,共3页
Journal of Apoplexy and Nervous Diseases
关键词
颅内多发动脉瘤
显微手术
血管内栓塞
治疗
Multiple Intracranial Aneurysms
Microsurgery
Endovascular embolization
Treatment
