36例颅内多发动脉瘤的治疗体会

Therapeutic strategies of multiple intracranial aneurysms

目的探讨颅内多发动脉瘤（MIA）的发生率、治疗原则和预后。方法采用回顾性分析，对36例共76个MIA的临床资料进行分析。结果14例行一侧翼点入路，夹闭动脉瘤28个，包裹2个。20例行介入栓塞40个动脉瘤。2例手术联合介入，夹闭动脉瘤4个，栓塞2个。GOS评分恢复优28例，轻残4例，重残2例，植物生存1例，死亡1例。结论应根据动脉瘤的位置和患者的具体情况，选择显微手术、介入栓塞或手术联合介入，尽可能地在早期一期处理所有的MIA，预后良好。

Objective To explore the incidence, principles of treatment and prognosis of muhiple intraeranial aneurysms. Method The clinical and imaging data of 36 patients with 76 aneurysms were analyzed retrospectively. Results 28 aneurysms were clipped and 2 were wrapped through single pterion approach in 14 patients. 40 aneurysms were treated with endovaseular therapy in 20 patients. 4 aneurysms were clippled and 2 were coiled with surgical treatment combined with endovaseular therapy in 2 patients. The clinical outcomes of these patients evaluated by Glasgow Outcome Scale grades were ： 28 persons without deficit,4 persons with minor deficit,2 persons with major deficit, 1 person was vegetative state and 1 person was dead. Conclusions At first days based on the sites of aneurysms and patient＇s conditions, all nmhiple intracranial aneurysms should be treated selectively by microsurgery or endovascular therapy in one stage whenever possible, and the prognosis is good.