颅内动脉瘤破裂出血假性动脉瘤形成的诊治体会  

Operative treatment of intracranial pseudoaneurysm

作　　者：孙怀宇[1] 王运杰[1] 佟志勇[1] 王鹏[2] 吴鹏飞[1] 刘源[1] 肖健奇[1] 陆威成[1] 

机构地区：[1]中国医科大学附属第一医院神经外科,沈阳110003 [2]辽宁省铁法煤业集团总医院神经外科

出　　处：《中华神经外科杂志》2010年第1期24-27,共4页Chinese Journal of Neurosurgery

基　　金：基金项目：国家十一五科技支撑课题（2006BA101A12）

摘　　要：目的探讨脑动脉瘤破裂后形成的假性动脉瘤的术前诊断和术中处理，以提高治愈率。方法收集我院从2004年至2008年收治具备假性动脉瘤特征的17例患者的临床资料、影像学资料和术中情况，进行回顾性分析。结果17例患者术前行CT、3D—CTA、DSA检查，诊断前交通动脉瘤7例，大脑中动脉瘤4例，大脑前动脉瘤6例。术前发生二次出血7例。本组均行开颅手术治疗，术中动脉瘤破裂出血12例。术后死亡1例，重度残疾1例，遗留肢体瘫痪4例。结论假性动脉瘤术前二次出血和术中出血率高。术前、术中必须积极预防动脉瘤破裂出血，减少病死率和病残率。Objective To investigate the mechanism of intracranial paeudoaneurysm forming, to enhance cure rate and decrease mortality and morbidity. Method Data from 17 patients underwent surgical treatment after 2004 were coUeeted. Clinical characteristics and surgical results of patients with intraeranial paeudoaneurysm were assessed. Results 17 eases were dignosised by CT. 3D - CTA. DSA and others clinical manifestations. All of the patients were treated by clipping/sticking the neck of aneurysm. 1 cases died, 1 cases was severe disability ,4 cases were mild disability. Conclusions Intracranial pseudoaneulysm is a special category in intracranial aneurysm. Bleeding rate was higher than other types in preoperation and interoperation. Early diagnosis is important in preventing secondly hemorrhage, early operation is necessary in decrease morbidity and mortality.

关 键 词：颅内动脉瘤 假性动脉瘤 外科治疗 

分 类 号：R651.1[医药卫生—外科学]