颅内动脉瘤破裂后形成假性动脉瘤的显微手术治疗

Microsurgery for false aneurysms formed after rupture of intracranial aneurysms

目的探讨颅内动脉瘤破裂出血后假性动脉瘤形成的早期诊断、手术治疗。方法回顾性分析我院2002年1月至2012年1月收治的13例颅内动脉瘤破裂出血伴有假性动脉瘤形成的患者临床资料,8例术前确诊,5例术中确诊,均经病理学检查确诊为假性动脉瘤。结果 13例患者均行动脉瘤夹闭+血肿清除手术治疗。术后3个月,根据GOS标准评定,9例恢复良好,2例中残,1例重残,1例死亡。结论颅内动脉瘤破裂后短期内可以在动脉瘤周围血肿内形成假性动脉瘤,此类患者尽早手术是必要的,术中要谨慎处理动脉瘤周围血肿,避免动脉瘤术中破裂影响治疗效果。

Objective To investigate early diagnosis and treatment of false aneurysms formed after the rupture of intracranial aneurysms. Method The clinical data of 13 patients with false aneurysms formed after the rupture of intracranial aneurysms, who underwent microsurgery from January, 2002 to January, 2012, were analyzed retrospectively. Results Of 13 patients with false aneurysms formed after the rupture of intracranial aneurysms, 9 were recovered well, moderately disabled and 1 severely disabled and 1 died 3 months after the surgery according to GOS. Conclusions The false aneurysm may be formed around the ruptured aneurysm. The microsurgery by which the necks of the real aneurysms are clipped and the hemotomas around them are evacuated should be performed as early as possible in order to reach good prognoses in the patients with false aneurysms formed after the rupture of intracranial aneurysms.