血管搭桥技术在颅内复杂动脉瘤治疗中的应用  

Application of vessel bypass in the treatment of complex intracranial aneurysms

作　　者：步啸[1] 孙正辉[1] 许百男[1] 武琛[1] 姜金利[1] 薛哲[1] 

机构地区：[1]解放军总医院神经外科,北京100853

出　　处：《中国现代神经疾病杂志》2012年第1期44-47,共4页Chinese Journal of Contemporary Neurology and Neurosurgery

摘　　要：目的探讨颅内外血管搭桥联合动脉瘤孤立术治疗颅内巨大型动脉瘤患者的有效性及长期预后。方法回顾2006年12月-2010年10月因颅内巨大型动脉瘤而施行颅内外血管搭桥联合动脉瘤孤立术患者的临床经过,根据术后临床症状和影像学改善程度评价手术良好率、病死率和搭桥血管闭塞率,Glasgow预后分级（GOS）标准评价患者近远期预后。结果 25例颅内巨大型动脉瘤患者近期（出院时）疗效良好率（GOS评分4～5分）为56.00%（14/25）、不良率（GOS评分1～3分）44.00%（11/25）,手术相关病死率8.00%（2/25）,血管闭塞率12.00%（3/25）;远期（随访期间）疗效良好率（GOS评分4～5分）78.95%（15/19）,不良率（GOS评分1～3分）21.05%（4/19）,病死率15.79%（3/19）,搭桥血管闭塞率10.53%（2/19）。结论颅内外动脉血管搭桥联合动脉瘤孤立术是治疗颅内巨大型动脉瘤的有效方法。Objective To evaluate the therapeutic effect and follow up outcomes of extracranial intracranial revascularization in giant intracranial aneurysms. Methods The therapeutic effect and outcomes of bypass surgery in the treatment for 25 patients with giant intracranial aneurysms （Dec. 2006 to Oct. 2010） were analysed. The favorable rate [Glasgow Outcome Scale （GOS）], occlusion rate and mortality were evaluated. Results The favorable rate （GOS 4-5） was 56.00% （14/25）, unfavorable rate （GOS 1-3） was 44.00% （11/25）, morbidity was 8.00% （2/25）, and occlusion rate was 12.00% （3/25）. When followed up on Otc. 2011, effective rate （GOS 4-5） was 78.95% （15/19）, the unfavorable rate （GOS 1-3） was 5.26% （1/ 19）, morbidity was 15.79% （3/19）, and occlusion rate was 10.53% （2/19）. Conclusion The extracranial intracranial revascularization is effective in the treatment for giant intracranial aneurysms.

关 键 词：颅内动脉瘤 脑血管重建术 荧光素血管造影术 

分 类 号：R739.410.4[医药卫生—肿瘤]