大脑中动脉夹层动脉瘤临床特点及治疗的荟萃分析

A clinical study on dissecting aneurysms of middle cerebral artery

目的 综合分析有关大脑中动脉夹层动脉瘤临床报道病例的临床表现、治疗特点以及预后情况。方法 用关键词途径对 1990年 1月～ 2 0 0 3年 5月 MEDL INE数据库进行光盘检索。对 3 4例临床确诊为大脑中动脉夹层动脉瘤的病例报道资料进行综合分析 ,并进行统计学处理。结果 大脑中动脉夹层动脉瘤无明显性别和临床表现上的差异 ,其好发于中动脉 M1段和 M2 段。破裂或未破裂的中动脉夹层动脉瘤的手术组预后均明显优于保守组 ,两者统计学差异明显。结论 大脑中动脉夹层动脉瘤是一种较为罕见的脑血管疾病。对于破裂或未破裂 (尤其是 M1段 )的大脑中动脉夹层动脉瘤应于诊断后早期进行手术干预 。

ObjectiveTo collect pool the published d at a of case reports about dissecting aneurysms of middle cerebral artery and analy ze its manifestation characteristics,treatment strategy and outcomes. MethodsMedline disc from 1990 to 2003 were selected for data source and those data included were analyzed by statistical procedures. ResultsThe data included 34 cases of patients with diss ecting aneurysms. Among them,there was no significant difference found in patie nts' gender and clinical manifestation. Dissecting aneurysm was more likely to occur in M 1 and M 2 portion. It was found that the surgical group achieved far better outcomes compared with the conservative group,no matter with hemorrhagic or isc hemic manifestations. ConclusionDissecting aneurysm seems to be one of the imp ortant causes in SAH and cerebral infarction of unverified origin. If a MCA diss ecting aneurysm is verified,especially located in proximal portion,surgical treatment must be considered.