破裂前循环颅内动脉瘤的早期手术治疗  

Early surgical treatment of ruptured anterior circulation aneurysms

作　　者：郭衍[1] 王敢[1] 高文伟[1] 陈世文[1] 王韧[1] 居世明[1] 曹合利[1] 

机构地区：[1]上海交通大学附属第六人民医院神经外科,上海200233

出　　处：《上海交通大学学报（医学版）》2011年第10期1496-1499,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的探讨破裂的前循环颅内动脉瘤的手术治疗策略。方法回顾分析43例破裂的前循环颅内动脉瘤患者的临床资料。患者均经动脉瘤夹闭或血管内治疗,23例行动脉瘤夹闭术,20例行血管内治疗。结果全部病例术后平均随访1年。手术恢复良好19例,轻度残疾1例,重度残疾2例,死亡1例;血管内治疗恢复良好18例,轻度残疾1例,死亡1例。发生症状性脑血管痉挛10例。结论对于早期破裂的前循环颅内动脉瘤,早期治疗能得到较好疗效,应根据具体情况采用简单、快速及尽可能保留正常解剖结构的治疗方法。治疗过程中,熟悉动脉瘤三维结构及完善术前计划尤为关键。早期治疗破裂的颅内动脉瘤可降低再出血的风险,有利于脑血管痉挛及脑积水的防治。Objective To investigate the surgical treatment of ruptured anterior circulation aneurysms. MethodsThe clinical data of 43 patients with ruptured anterior circulation aneurysms were retrospectively analysed.Twenty-three patients underwent surgical clipping,and the other 20 patients received endovascular treatment. ResultsPatients were followed up for an average of 12 months after operation.Of the 23 patients with surgical clipping,19 achieved a favorable outcome,1 resulted in mild disability,2 ended up in severe disability,and the other 1 was dead.Of the 20 patients with endovascular treatment,18 achieved a favorable outcome,1 resulted in mild disability,and the other 1 was dead.Symptomatic vasospasm occurred in 10 patients. ConclusionEarly treatment of ruptured anterior circulation aneurysms may lead to favorable outcomes.Simple,fast and normal anatomy-preserving strategy should be adopted for the treatment of anterior circulation aneurysms.Proper understanding of three-dimensional structure of aneurysms before operation and appropriate preoperative planning are of great importance.Early treatment of ruptured anterior circulation aneurysms can prevent the risks of rerupture and benefit the prevention and treatment of vasospasm and hydrocephalus.

关 键 词：前循环颅内动脉瘤 破裂 治疗 

分 类 号：R651.1[医药卫生—外科学]