分叶状颅内破裂动脉瘤血管内治疗体会

Clinical experience of endovascular treatment for ruptured and lobulated intracranial aneurysms

目的探讨分叶状颅内破裂动脉瘤血管内治疗的方法、注意事项及临床效果。方法收集自2006年1月至2012年10月解放军第二六四医院神经外科诊治的89例分叶状颅内破裂动脉瘤患者（均行血管内介入治疗），对其相关临床资料行回顾性分析。结果术中1例发生动脉瘤破裂，2例术后发生血栓栓塞症状；栓塞后血管造影，其中完全栓塞76例（85．39％），大部分栓塞13例（14．61％1；术后3个月格拉斯哥预后量表（GOS）评估为恢复良好69例（77．53％），轻度残疾12例（13．48％），重度残疾7例（7．97％），死亡1例（1．12％）。结论对分叶状颅内破裂动脉瘤采取血管内介入治疗，安全性高，临床效果好，复发率低。

Objective To explore the methods, matters needing attention and clinical effects of endovascular treatment on ruptured and lobulated intracranial aneurysms. Methods Eighty-nine patients with lobulated intracranial aneurysms treated with endovascular treatment in our hospital from January 2006 to October 2012 were chosen in our study; their clinical data were retrospectively analyzed. Results Intraoperative aneurysm rupture occurred in 1 patient and 2 had postoperative thrombosis symptoms. Immediate angiography showed that 76 patients （85.39%） enjoyed complete embolization, 13 （14.61%） had arterial embolization. After 3 months, the clinical effects were studied on the basis of Glasgow Outcome Scale （GOS） scores; good recovery was noted in 69 patients （77.53%）, mild disability in 12 （13.48%）, severe disability in 7 （7.97%） and death in 1 （1.12%）. Conclusion Endovascular treatment for ruptured and lobulated intracranial aneurysms is a high safety method, with good clinical effect and low recurrence rate.