一期手术治疗颅内多发动脉瘤

Single-stage surgical treatment of multiple intracranial aneurysms

目的 探讨颅内多发动脉瘤的治疗方法和各种方法之间的利与弊。方法 经一期手术治疗颅内多发性动脉瘤 2 5例 ,其中 ,男 8例 ,女 17例 ,最大年龄 73岁 ,最小 2 9岁 ,平均 5 4 2岁。2 5例中查出动脉瘤 5 6个 ,其中颈内 后交通动脉瘤 17个 ,大脑中动脉瘤 2 3个 ,前交通动脉瘤 4个 ,颈内 脉络膜前动脉瘤 6个 ,颈内动脉分叉部动脉瘤 2个 ,颈内 眼动脉段动脉瘤 2个 ,大脑前动脉远端动脉瘤 2个。根据形态特点囊性动脉瘤 5 1个 ,梭形动脉瘤 5个。 2 5例均行翼点入路 ,单侧开颅 6例 ,双侧开颅 19例 ;夹闭动脉瘤 5 1个 ,包裹 5个。结果 2 5例手术全部成功 ,存活率 10 0 % ,经半年的随访 ,仍有 2例偏瘫 ,1例植物生存。 3例动眼神经瘫尚在恢复中 ,6例脑积水中 ,有 4例手术后脑室缩小 ,2例无明显变化。结论 如果患者全身状态允许及动脉瘤的位置和性状合适 ,一期手术治疗颅内多发性动脉瘤是安全和可行的 ,效果是良好的。

Objective To explore the treatment of the patients with multiple intracranial aneurysms. Methods 25 patients with multiple intracranial aneurysms were treated by single-stage operation.Among of 25 these patients, there were 56 aneurysms. 17 aneurysms were located in the posterior communicating artery, 23 in the middle cerebral artery, 6 in the anterior communicating artery and anterior cerebral artery, 6 in Ic-Ach, 2 in Ic-Bif, 2 in Ic-Oph. 6 patients were operated by unilateral cranio tomy and 19 patients were operated by bilateral cranio tomy 51 aneurysms were clipped and 5 aneurysms were wrapped. Results The rate of success in the operation is 100%, 25 patients have been followed up for 6 months, there was limb paralysis of one side in 2 patients, vegetatcve statu in 1 patient. Conclusions If the preoperative condition of patients surgery is good, single-stage for multiple intracranial aneurysms is safety and the outcome can be good.