颅内动脉瘤外科治疗500例经验(英文)

Intracranial aneurysms: experience in treating 500 patients

目的 总结手术治疗颅内动脉瘤的经验和措施。 方法 回顾性总结外科治疗的 5 0 0例Ⅰ～Ⅴ级颅内动脉瘤患者的临床资料 ,包括动脉瘤的分级、手术时机的选择、控制性低血压麻醉、脑保护剂与暂时载瘤动脉阻断结合应用、经颅多普勒超声监测、抗血管痉挛治疗、直接手术夹闭和导管栓塞等。 结果 46 5例手术治疗 ,手术病死率2 7%。 1990年前 2 10例病死率 3 8% ;1990年后 2 5 5例病死率 1 9% (35例动脉瘤栓塞无出血死亡 )。

Objective To summarize the experience in surgical treatment of patients with intracranial aneurysms. Methods The measures used in the treatment of 500 patients with intracranial aneurysms were retrospectively reviewed with regard to timing of surgery, induced hypotensive anesthesia, brain protection combined with temporal occlusion of the feeding artery, dynamically monitoring of transcranial Doppler ultrasound, antivasospasm treatment, techniques of direct surgery, and endovascular embolization. Results In 465 patients undergoing surgery, intraoperative rupture was observed in 27(6 2%), postoperative death in 13(2 7%), hemipalsy in 8(2 2%), and vegetative state in 2(5 0%). The operative mortality was 3 8% in 210 patients before 1990, while 1 9% in 255 patients after 1990.Conclusion The outcome of patients with intracranial aneurysms can be markedly improved by comprehensive measures.