649例动脉瘤的治疗经验

Intracranial aneurysm： experience in treating 649 patients

目的探讨颅内动脉瘤患病的危险因素，无症状动脉瘤治疗方法的选择。方法回顾性分析649例颅内动脉瘤的临床资料，其中535例（82．4％）行动脉瘤蒂夹闭术，动脉瘤孤立术19例（2．9％），包裹术17例（2．6％），血管内治疗46例（7．1％），32例（5％）无症状病例未予特殊治疗，仅随诊。结果术后12例死亡，手术死亡率1．9％。动脉瘤的后天患病的危险因素包括高血压、女性、高龄、吸烟。结论动脉瘤的后天患病危险因素包括高血压、女性、高龄以及吸烟。对于部分无症状动脉瘤无需治疗，随诊是其合适的选择。

Objective To explore risk factors for the development of intracranial aneurysms, and the selection of therapeutic methods for unruptured intracranial aneurysms. Method We retrospectively reviewed the data of the treatment of 649 patients, including clipping of aneurysm 535 cases （ 82.4% ） , isolation of aneurysm 19 cases （ 2. 9% ） , and coating of the aneurysm 17 cases （ 2. 6% ） , endovascular treatment 46 cases （7. 1% ） ,follow up symptomless patients 32 cases（5% ）. Results 12 cases died after operation ,the overall operative mortality was 1.9%. We identified hypertension, female sex, advanced age, and smoking as significant risk factors for sporadic intracranial aneurysms. Conclusions Hypertension, female, sex, advanced age, and smoking are significant risk factors for sporadic intracranial aneurysms. Follow up is a good choice for some symptomless patients.