颅内动脉瘤显微手术治疗专家共识(2025版)  

Consensus statements on microsurgical treatment of intracranial aneurysms(2025 edition)

作　　者：颅内动脉瘤显微手术治疗专家共识工作组 毛颖 张鸿祺[3] 曹勇[4] 杭春华 郎黎薇[6] 李培良 林元相[7] 刘佩玺[6] 刘翼 罗猛强 倪伟[6] 全凯[6] 孙浩耕 徐燕[6] 朱巍[6] Expert Consensus Working Group on Microsurgical Treatment of Intracranial Aneurysms;Mao Ying;Zhang Hongqi;Cao Yong(不详;Department of Neurosurgery,Huashan Hospital,Fudan University,Shanghai 200072,China;Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]不详 [2]复旦大学附属华山医院神经外科,上海200072 [3]首都医科大学宣武医院神经外科,北京100053 [4]首都医科大学附属北京天坛医院神经外科,北京100070 [5]南京医科大学附属鼓楼医院 [6]复旦大学附属华山医院 [7]福建医科大学附属第一医院 [8]四川大学华西医院

出　　处：《中华外科杂志》2025年第3期187-202,共16页Chinese Journal of Surgery

摘　　要：开颅显微手术治疗颅内动脉瘤,具有动脉瘤复发率低、手术费用低、血流重建方式成熟等优势。目前,开颅手术面临手术量下降、患者倾向微创介入治疗、部分介入手术医师缺乏开颅手术技能等诸多挑战。同时,动脉瘤显微手术尚缺乏统一规范。鉴于此,由我国神经外科及介入领域专家组成颅内动脉瘤显微手术治疗专家共识工作组,针对颅内动脉瘤的流行病学、治疗策略、手术适应证、术前评估、麻醉管理、开颅夹闭治疗、血流重建治疗、复合手术应用、并发症处理及预后、护理与康复等问题进行反复讨论,采用改良德尔菲法征集专家建议,形成10个方面共62条共识推荐意见,为颅内动脉瘤显微手术治疗提供科学且切实可行的临床指导方案。Microsurgical treatment of intracranial aneurysms has irreplaceable advantages such as lower recurrence rates,lower costs,and mature strategies for blood flow reconstruction.Currently,open microsurgical faces numerous challenges,including patients′preference for minimally invasive interventions,a decline in the volume of open surgeries,and some interventionalists lacking a surgical background.Additionally,regional disparities within the country lead to a lack of standardized guidelines for microsurgical treatment of intracranial aneurysms.In response,the expert consensus working group on microsurgical treatment of intracranial aneurysms composed of nationwide experts in neurosurgery and interventional fields was formed to discuss and address issues related to the epidemiology,treatment selection and surgical indications,preoperative evaluation,anesthesia management,open clipping techniques,blood flow reconstruction,hybrid surgical applications,complication management and prognosis,as well as nursing and rehabilitation.Using a modified Delphi method to gather expert recommendations,the group developed 62 consensus recommendations across 10 areas,providing scientific and practical clinical guidance for the microsurgical treatment of intracranial aneurysms.

关 键 词：颅内动脉瘤 蛛网膜下腔出血 显微手术治疗 共识 德尔菲法 

分 类 号：R651.12[医药卫生—外科学]