多发性颅内动脉瘤的治疗  

Treatment of multiple intracranial aneurysm

作　　者：杨华[1] 凌锋[2] 王大明[2] 宋庆斌[2] 李萌[2] 张鸿祺[2] 缪中荣[2] 郝蔓春[2] 

机构地区：[1]贵阳医学院附属医院神经外科,550004 [2]北京医院介入神经放射学研究中心,100730

出　　处：《中华外科杂志》2001年第1期39-41,T001,共4页Chinese Journal of Surgery

摘　　要：目的　比较显微外科与血管内治疗对多发性颅内动脉瘤 (MIA)的治疗效果和并发症发生率的差别。　方法　回顾分析 2 0例MIA(共 46个动脉瘤 ) ,根据MIA所在部位的区域分级标准 ,Ⅰ级 8例 (占 40 % ) ,Ⅱ级 10例 (占 5 0 % ) ,Ⅲ级 2 (占 10 % )。级别越高者 ,多倾向于选择血管内治疗。　结果　显微外科手术组 8例 ,共 19个动脉瘤 ,18个镜下全部夹闭、1个没发现未夹闭。血管内治疗组8例 ,共 17个动脉瘤 ,14个 10 0 %闭塞、1个 90 %以上闭塞、2个因动脉瘤小导管不能到位未治。颅内外血管搭桥加颈内动脉闭塞 2例。未治 2例。　结论　MIA所在部位的区域分级有助于治疗方法的选择 ,对MIA多倾向于血管内治疗 ,必要时可 2种方法联合应用。Objective To study the results of embolization with MDS or GDC coils in patients with multiple intracranial aneurysms (MIA). [WT5”HZ]Methods[WT5”BZ] We retrospectively studied 20 patients with MIA (46 aneurysms). According to our standard of zone classification, 8 patients belonged to grade Ⅰ (40%), 10 grade Ⅱ (50%), 2 grade Ⅲ (10%). MDS or GDC embolization was used for the treatment of high grade patients. [WT5”HZ]Results[WT5”BZ] In microsurgery group (8 patients), 18 aneurysms were eliminated and one untreated.In endovascular group (8 patients) 14 aneurysms were occluded, one was almost occluded (>90%), and 2 were untreated because of their small size. In EC IC bypass + balloon occlusion of the internal carotid artery (2 patients), complete occlusion was achieved in 2 giant aneurysms, and 2 aneurysms were untreated. [WT5”HZ]Conclusions[WT5”BZ] Zone classification of MIA is helpful to select, treatment. We frefer to endovascular treatment for MIA or combined microsurgical and endovascular approaches if necessary.

关 键 词：栓塞治疗 显微外科手术 脑血管重建术 弹簧圈栓塞 多发性颅内动脉瘤 

分 类 号：R732.2[医药卫生—肿瘤]