颅内微小动脉瘤手术方法的探讨  

The Investigation of Surgical Treatment Managements of Intracranial Microaneurysms

作　　者：胡小辉[1] 刘建刚[1] 黄亚波[1] 吴江[1] 张世明[1] 

机构地区：[1]苏州大学附属第一医院神经外科,215006

出　　处：《中国临床神经科学》2016年第1期15-21,共7页Chinese Journal of Clinical Neurosciences

基　　金：国家自然科学基金项目(编号:81371280);江苏省医学重点学科基金项目(编号:xk2007227)

摘　　要：目的探讨颅内微小动脉瘤手术治疗的方法及其安全性和有效性。方法回顾性分析27例颅内微小动脉瘤患者经手术治疗的33个直径≤4 mm微小动脉瘤的临床资料,总结颅内微小动脉瘤的手术治疗方法,并分析其安全性及有效性。结果经手术治疗的33个微小动脉瘤中,直接夹闭10个,棉片辅助夹闭23个。手术中有2个微小动脉瘤瘤颈撕裂,以载瘤动脉破口为中心,用棉片辅助动脉瘤夹闭术成功修补破口。术后随访3周至8年,平均38.6个月,复查DSA或CTA提示动脉瘤均消失,无动脉瘤再出血或复发。格拉斯哥预后评分(GOS)恢复良好26例,1例因术后时间短,正在康复中。结论棉片辅助夹闭术治疗颅内微小动脉瘤是一种安全、有效、可行的方法。Aim To investigate the safety and efficacy of surgical treatment managements of intracranial microaneurysms. Methods A retrospective analysis of clinical data of 27 cases with 33 intracranial aneurysms（diameter less than 4 mm）was performed, the therapeutic managements of intracranial microaneurysms were summarized, and the safety and efficacy of surgical treatment managements were analyzed. Results Of the 33 surgical treated microaneurysms, 10 microaneurysms were clipped directly, 23 microaneurysms were clipped with cotton assisted. In the operation, 2 microaneurysm necks were torn and repaired triumphantly with cotton assisted clipping in the center of aneurysm rupture. All cases were followed up 3 weeks to 8 years after the operation, the mean time was 38.6 months. Postoperative DSA or CTA showed aneurysms disappeared, and there was no rebleeding and recurrence. According to Glasgow outcome score（GOS）, good outcome occurred in 26 cases, and 1 case was still in the rehabilitation because of short postoperative time. Conclusion Cotton assisted clipping treatment of intracranial microaneurysms is a safe, effective and feasible method.

关 键 词：微小动脉瘤 破裂 滑脱 棉片辅助夹闭术 

分 类 号：R651.12[医药卫生—外科学]