20例颅内巨大动脉瘤的手术治疗体会  

作　　者：李智[1] 赵克非[1] 罗泽旭 赵祥启 郭博[1] 

机构地区：[1]鞍山第四医院神经外科,辽宁鞍山114034

出　　处：《中国医疗前沿（学术版）》2008年第12期44-45,共2页China Healthcare Innovation

摘　　要：目的报告20例颅内巨大动脉瘤,重点探讨其病理和临床特点及外科治疗方法。方法20例中19例有蛛网膜下腔出血、脑受压以及脑缺血等症状,动脉瘤分别位于颈内动脉6例,大脑前动脉5例,大脑中动脉4例,椎基底动脉5例,全部接受手术治疗。结果好16例,差2例,死亡2例。结论对颅内巨大动脉瘤应采取积极的外科治疗,手术应根据情况采用载瘤动脉临时阻断,动脉瘤减压、组合夹闭,载瘤动脉塑形,血管重建以及深低温停循环等综合手段。而不是简单夹闭动脉瘤,才能取得较好的效果。Objective To study their patholigical and clinical characters as well as surgical treatments through 20cases of giant intraeranial aneurysms. Methods Nineteen of 20patients had symptoms of subarachnoid hemorrhage,cerebral compreession,cerebral ischemia,and others.The aneurysms located at internal carotid artery in6cases,anterior cerebral artery in5cases,middle cerebral artery in 4 eases,and vertebrobasilar artery 5cases respectively.The surgeries were taken in all of 20cases.Results Surgical outcomes were good in 16＂eases,poor in2 cases,arid dead m2cases. Conclusions The aggressive surgical treatment should be taken into account for symptomatic giant aneurysms.Muhidisciplinary alternative surgical modalities instead of conventional clipping should be chosen properly based on the variant cases,which includes temporary occlusion of parent artery, collapse of aneurysms,thrombectomy,tandem clip placement,clip reconstruction of aneurysm or parent artery,revascularization,and profound cardiac circulatory arrest.

关 键 词：巨大 颅内 动脉瘤 手术 

分 类 号：R739.41[医药卫生—肿瘤]