颅内动脉瘤的显微手术治疗

Microsurgical Treatment of Intracranial Aneurysms

目的 探讨颅内动脉瘤手术治疗的时机和术中注意事项。方法 回顾分析应用显微神经外科技术对64例71枚动脉瘤进行的直视手术及其疗效。结果 8枚动脉瘤夹闭后切除,1枚梭型动脉瘤作包裹术,其余均作夹闭术。术中动脉瘤破裂13例。Hunt Ⅱ级以内动脉瘤的良好率为94.7％(36/38),无死亡,Ⅲ级以内动脉瘤的良好率为88.1％(52/59),死亡率为3.4％(2/59)。结论 显微神经外科手术是颅内动脉瘤有效、安全的治疗方法,但应选择适当的时机进行。

Objective To evaluate the time and skill of surgical treatment for intracranial aneurysms. Method Data of 71 aneurysms (64 patients) operated under the operating microscope were analysed retrospectively. Results Eight aneurysms were excised after clipping them, 1 fusiform aneurysm was wrapped and the others were clipped. There were 13 aneurysms ruptured during the operation. The satisfactory results were obtained in 94.7% (36/38) of the cases with Hunt grade 0-Ⅱaneurysms and no patient died, while 88.19% (52/59) had good results and 3.4% (2/59) died in the patients with Hunt grad 0-Ⅲ aneurysms. Conclusion Skillful microneurosurgery is an effective and safe therapeutic option in treatment of the intracranial aneurysms, but appropriate opportunity of the operation should be selected.