51例大脑中动脉瘤破裂患者的临床特点 影像学 显微手术及预后研究  

Research on clinical features,imaging characteristics,microsurgery and prognosis of 51 cases with ruptured middle cerebral artery aneurysms

作　　者：林其昌[1] 林少华[1] 黄汉添[1] 廖巍[1] 

机构地区：[1]中山大学附属中山医院,中山528400

出　　处：《中国实用神经疾病杂志》2015年第6期10-12,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的：探讨大脑中动脉瘤（MCAA）临床特点、影像学特征及显微手术治疗方法及预后。方法回顾性分析51例M C A动脉瘤的临床特点、影像学特征、手术方法及预后。结果动脉瘤夹闭43例，夹闭加包裹4例，包裹加固3例，孤立1例。随访3～12月，按照GOS评分，其中5分29例，4分11例，3分4例，2分2例，1分5例。预后较差者（重残至死亡）主要为Hunt-HessⅣ、Ⅴ级者。结论及早而准确诊断动脉瘤，熟练掌握手术时机及显微操作技术能够提高颅内动脉瘤疗效，针对不同的病情采用不同的手术方法与策略，术中保护MCA及保持周围相关血管的通畅是手术的关键。Objective To investigate clinical features ,imaging features and microsurgical treatment and prognosis of mid-dle cerebral artery aneurysms. Methods Clinical manifestations ,imaging features ,operative methods and prognosis of 51 cases with MCA aneurysms were analyzed retrospectively.Results 43 cases were clipped ,4 cases were clipped and wrapped ,3 cases were wrapped strengthened ,1 case was isolated. The follow-up periods ranged from 3 to 12 months ,according to GOS assess-ment ,the results showed 29 patients with 5 points ,11 patients with 4 points ,4 patients with 3 points ,2 patients with 2 points ,5 patients with 1 point. Those with poor prognosis （ severe disability to death ） were mainly for Hunt-Hess Ⅳ ,Ⅴgrade. Conclusion Early and accurate diagnosis of aneurysm ,skilled master of microsurgical technique and surgery time can improve the prognosis of middle cerebral artery aneurysms. Microsurgy and treatment strategy were based on personalized con-dition of patients with MCAAs ,the intraoperative protection of MCA and relative vascular branches is the key to good prog-noses in the patients with MCAA treated with microsurgery.

关 键 词：大脑中动脉瘤 显微手术 临床特点 影像学特征 预后 

分 类 号：R732.21[医药卫生—肿瘤]