颅内多发动脉瘤的显微手术治疗

发布时间：2018-12-05 20:22

【摘要】：目的探讨颅内多发动脉瘤显微手术治疗的策略、手术时机及效果。方法回顾性分析2014年12月至2017年6月,采用显微手术治疗的30例颅内多发动脉瘤患者的临床资料。其中男6例,女24例;年龄38~79岁,平均年龄56.13岁。手术策略包括一期手术(一次手术处理所有动脉瘤),二期手术(分期手术处理全部动脉瘤)及部分治疗(仅处理责任动脉瘤)。全部患者术前均行头颅CT血管成像(CTA)或DSA检查;术后用格拉斯哥预后量表(GOS)评分进行疗效评定。结果一期手术者20例,二期手术者3例,部分治疗者7例。GOS评分5分(恢复良好)者20例,4分(轻度残疾)3例,3分(重度残疾)4例,2分(植物生存)1例,1分(死亡)2例。结论颅内多发动脉瘤的显微手术治疗较复杂;应制订个性化的手术方案,优先处理责任动脉瘤,选择合适的手术时机尽早手术,一期手术与二期手术相结合,可达到最佳的治疗效果。
[Abstract]:Objective to explore the microsurgical strategy, timing and effect of microsurgical treatment for multiple intracranial aneurysms. Methods the clinical data of 30 patients with multiple intracranial aneurysms treated by microsurgery from December 2014 to June 2017 were retrospectively analyzed. There were 6 males and 24 females with an average age of 56.13 years. Surgical strategies include one stage operation (one operation for all aneurysms), two stage operation (stage operation for all aneurysms) and partial treatment (only responsible aneurysms). All patients were examined by (CTA) or DSA with CT angiography before operation, and the curative effect was evaluated with Glasgow prognosis scale (GOS) after operation. Results there were 20 cases of primary operation, 3 cases of secondary operation, 7 cases of partial treatment. The GOS score was 5 (good recovery) in 20 cases, 4 (mild disability) in 3, 3 (severe disability) in 4, and 2 (vegetative survival) in 1. 1 score (death) 2 cases. Conclusion the microsurgical treatment of multiple intracranial aneurysms is complicated. We should make individualized operation plan, give priority to the treatment of responsible aneurysms, select the right time of operation as early as possible, and combine one-stage operation with second-stage operation to achieve the best therapeutic effect.
【作者单位】：徐州医科大学附属医院神经外科;安徽医科大学第一附属医院神经内科ICU;
【基金】：江苏省333高层次人才培养工程(2015201020)
【分类号】：R651.12

【相似文献】