摘要
目的探讨颅内多发动脉瘤的诊治策略、手术时机、手术方法及影响手术疗效的相关因素。方法回顾分析巴州人民医院2011年1月-2016年9月收治的15例颅内多发动脉瘤病例,共计37个动脉瘤。动脉瘤=2个占66.7%,动脉瘤=3个占20%,动脉瘤=4个占13.3%。采取显微手术治疗15例,其中显微一期手术10例,二期手术5例,实施直接夹闭35个,动脉瘤包裹2个。结果 15例患者术后第二日常规行CT及CTA检查,1例因病情危重未行检查,CTA重建后结果显示动脉瘤夹闭满意,CT影像显示4例有不同程度缺血表现。随访3个月至5年,术后恢复良好12例、重残2例、死亡1例。结论判断可能出血的责任动脉瘤并积极治疗,对于非责任病灶需要综合评估出血风险,采取个体化治疗措施,同时根据动脉瘤的部位、Hunt-Hess临床分级等因素,择期手术处理多发动脉瘤,可以达到最佳的治疗效果。
Objective To explore the diagnosis and treatment strategy, operation timing, operation methods and related factors of intracranial multiple aneurysms （MIA）. Methods A retrospective analysis among 15 patients amounted to 37 intracranial multiple aneurysms （including aneurysm = 2, 66.7%; aneurysm = 3, 20%; aneurysm --4, 13.3% ） in Bazhou People＇s Hospital from January 2011 to September 2016 was carried out. Microsurgical treatment were proceeded in 15 patients, There were 10 cases who were given primary operations and 5 cases who were proceeded secondary operations. , 35 aneurysms were directly clipped and 2 aneurysms were wrapped. Results At the second day after operations, CT and CTA were performed routinely. One case was not examined because of serious illness. CTA revealed satisfactory aneurysm clipping effect. CT showed 4 cases had different degrees of ischemia. Follow-up showed there were good postoperative recovery in 12 cases, 2 cases having severe disability, 1 cases getting death from 3 months to 5 years. Conclusion According to the location of aneurysm, Hunt-Hess clinical grading and other factors, curing multiple aneurysms with one or two stage treatment or aggressively treating aneurysm need to be integrated assessment about bleeding risk. It is needed to take individualized treatment measures in order to achieve the best therapeutic effect.
出处
《新疆医学》
2017年第3期261-263,278,共4页
Xinjiang Medical Journal
关键词
多发动脉瘤
手术
治疗效果
Multiple aneurysms
Surgery, Therapeutic effect
