破裂的椎基底动脉瘤的治疗选择  

The choice of treatment for ruptured vertebrobasilar aneurysms

作　　者：王志刚[1] 丁璇[1] 曲春城[1] 王成伟[1] 冀勇[1] 潘顺[1] 郝晓光[1] 李卫国[1] 张纪庆[1] 

机构地区：[1]山东大学第二医院神经外科,济南250033

出　　处：《中华神经外科杂志》2008年第8期576-578,共3页Chinese Journal of Neurosurgery

摘　　要：目的探讨破裂的椎基底动脉瘤血管造影的影像学表现与治疗方法选择的关系。方法共收治42例，计43个椎基底破裂动脉瘤，其中手术夹闭9例，载瘤动脉闭塞术8例，单纯微弹簧圈栓塞12例，支架结合微弹簧圈栓塞13例。结果40例病人术后即刻造影显示完全闭塞，2例大部闭塞，34例术后3．12个月随访，2例复发，1例病人死亡。结论椎基底动脉瘤的治疗方法应根据动脉瘤的部位、形态与周围血管的关系而选择，血管内介入治疗应作为首选；手术夹闭适合病变相对易于暴露、术前全身状态较好或急需清除血肿挽救生命的病例。Obective To study the relationship between the manifestation of angiography and the choice of treatment for ruptured vertebrobasilar aneurysms. Methods Fourty-two patients with 43 ruptured vertebrobasilar aneurysms were treated with surgical clipping （9 patients）, parent artery occlusion （8 patients）, coil embolization （12 patients） and stent-assisted coiling （13 patients）. Results The angiograms of 42 patients showed complete occlusion （40 patients ） and nearly complete occlusion （2 patient）. In the follow-up period （3-12 months） of 34 patients, one case of death and two cases of reoccurrence were observed. Conclusions The choice of treatment of ruptured vertebrobasilar aneurysm should be considered according to the location, configuration and collateral circulation of the aneurysm. The application of clipping of aneurysms should be limited, and the intravascular interventional therapy is becoming the first choice.

关 键 词：椎基底动脉瘤 脑血管造影术 治疗学 

分 类 号：R686[医药卫生—骨科学]