脑动脉瘤破裂开颅夹闭和介入栓塞治疗的临床分析  

Surgical Clipping or Interventional Embolization for the Treatment of Cerebral Aneurysm Rupture: A Clinical Analysis

作　　者：邓东峰[1] 李茂全[2] 刘建民[3] 张庆[2] 陶妙娣[1] 周勇[2] 

机构地区：[1]上海同济大学附属东方医院神经外科,200120 [2]上海同济大学附属东方医院介入中心,200120 [3]第二军医大学附属长海医院神经外科

出　　处：《临床放射学杂志》2003年第10期873-876,共4页Journal of Clinical Radiology

摘　　要：目的　研究脑动脉瘤破裂在开颅夹闭和介入栓塞治疗上的临床特点 ,处理方法 ,危险因素及预后。资料与方法　系统地回顾性分析 78例 (80枚 )经开颅夹闭和介入栓塞治疗破裂的脑动脉瘤 ,男 2 9例 ,女 49例 ,年龄 15～75岁 ,并将其分为A(介入栓塞 42例 )、B(开颅夹闭 36例 )两组 ,平均年龄A组为 6 1岁 ,B组为 5 7岁。结果　开颅夹闭治疗 36例 ,1例重残 ,1例死亡 ;介入栓塞治疗 42例 ,2例重残 ,无死亡病例 ;Hunt Hess分级Ⅲ级以下两组治疗结果无统计学差异。结论　介入栓塞治疗能处理形态各异和手术不能达到部位的动脉瘤 ,而大脑中动脉三分叉处宽颈或巨大动脉瘤开颅夹闭则优于介入栓塞治疗。Objective To study the clinical features, management, risk factors and prognosis of ruptured cerebral aneurysms which were treated with surgical clipping or interventional embolization.Materials and Methods Surgical clipping or interventional embolization was performed in 78 patients (29 males and 49 females, ages 15～75) with 80 ruptured cerebral aneurysms. Group A (interventional embolization group) had 42 cases with a mean age of 61. Group B (surgical clipping group) had 36 cases with mean age of 57. No statistic difference in clinical data existed between the two groups (P>0.05). Function level before and after the therapy was evaluated with Hunt-Hess classification.Results In group A, serious disablement and death occurred in one case each. In group B, serious disablement occurred in two cases and no death occurred. No statistic difference in Hunt-Hess evaluation was found between two groups after treatment. Conclusion Interventional embolization should be considered as the first choice for cerebral aneurysm with its location hardly to be reached by surgical procedure, while for the aneurysms having huge size or being located at the bifurcation of cerebral middle artery surgical clipping treatment is superior to interventional embolization.

关 键 词：脑动脉瘤破裂 开颅夹闭 介入栓塞治疗 危险因素 预后 并发症 

分 类 号：R739.4[医药卫生—肿瘤]