老年人颅内破裂动脉瘤的临床特点和早期血管内介入治疗  

Clinical characteristics and early endovascular treatment of ruptured intracranial aneurysms in elderly patients

作　　者：洪景芳[1] 王守森[1] 刘峥[1] 郑兆聪[1] 张尚明[1] 

机构地区：[1]南京军区福州总医院神经外科,福州350025

出　　处：《中国微侵袭神经外科杂志》2014年第12期543-545,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨老年人颅内破裂动脉瘤的临床特点和早期血管内治疗的临床效果。方法回顾性分析27例采取血管内治疗方法的老年人颅内破裂动脉瘤的临床资料。共32个动脉瘤,其中24个动脉瘤以弹簧圈单纯栓塞,5个宽颈动脉瘤采取支架辅助弹簧圈栓塞,1个小脑后下远端动脉瘤采取Onyx闭塞动脉瘤及载瘤动脉,2个动脉瘤未栓塞。结果栓塞动脉瘤30个,其中完全栓塞18个(60%),次全栓塞8个(26.7%),不全栓塞4个(13.3%)。术后3个月GOS评分:5分(恢复良好)20例,4分(轻度残疾)4例,3分(重度残疾)1例,1分(死亡)2例。结论早期血管内栓塞是老年人颅内破裂动脉瘤一种安全、有效的治疗方法。Objective To explore the clinical characteristics and early endovascular treatment of ruptured intracranial aneurysms in elderly patients. Methods The clinical data of 27 patients older than 60 years with ruptured intracranial aneurysms were analyzed retrospectively. There were 32 intracranial aneurysms, of them, 24 aneurysms by coil embolization alone, 5 wide necked aneurysms by stent-assisted coil embolization and one aneurysm located at the distant segment of the posterior inferior cerebellar artery （PICA） by occlusion of both the aneurysm and its parent artery with Onyx and 2 aneurysms without embolization. Results Thirty aneurysms were treated successfully. Of the 30 embolized aneurysms, there were compact embolization in 18 （60%）, incomplete in 8 （26.7%） and partial in 4 （13.3%）. The Glasgow Outcome Scale （GOS） at 3 months post procedure showed 5 scores （a good result） in 20 patients, 4 scores （medium disability） in 4, 3 scores （severe disability） in 1 patient and 1 score （death） in 2. Conclusions Early endovascular treatment is a safe and effective therapeutic approach in elderly patients with ruptured intracranial aneurysms.

关 键 词：颅内动脉瘤 老年人 栓塞 

分 类 号：R651.12[医药卫生—外科学]