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颅内巨大动脉瘤的手术治疗

Surgical treatment intracranial aneurysms of giant

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【作者】 许百男周定标余新光张远征姜金利孟祥辉佟怀宇孙正辉张纪段国升

【Author】 XU Bai-nan ZHOU Ding-biao YU Xin-guang et al. Department of Neurosurgerg, General Hospital of PLA Beijing 100853, China

【机构】 解放军总医院神经外科解放军总医院神经外科 100853北京100853北京

【摘要】 目的报告40例颅内巨大动脉瘤,重点探讨其病理和临床特点及外科治疗方法。方法40例中38例有蛛网膜下腔出血、脑受压以及脑缺血等症状,动脉瘤分别位于颈内动脉12例,大脑前动脉9例,大脑中动脉8例,椎基底动脉11例,全部接受手术治疗。结果好33例,差4例,死亡3例。结论对颅内巨大动脉瘤应采取积极的外科治疗,手术应根据情况采用载瘤动脉临时阻断,动脉瘤减压、组合夹闭,载瘤动脉塑形,血管重建以及深低温停循环等综合手段。而不是简单夹闭动脉瘤,才能取得较好的效果。

【Abstract】 Objective To study their pathological and clinical characters as well as surgical strategy of 40 cases of giant intracranial aneurysms. Methods Thirty-eight out of 40 patients had symptoms of subaracnoid hemorrhage cerebral compression cerebral ischemia and others. The aneurysms located at intracrotid artery in 12 cases anterior cerebral artery in 9 cases middle cerebral artery in 8 cases and vertebrobasilar artery in 11 cases respectively. The operations were performed in all of 40 cases. Results Surgical outcomes were good in 33 cases poor in 4 cases and dead in 3 cases. Conclusions The aggressive surgical treatment should be considered for giant aneurysms. Multidisciplinary surgical strate gies instead of simple clipping should be chosen properly based on the variant factors which includes temporary occlusion of parent artery collapse of aneurysms  tandem clip and placement clip reconstruction of aneurysm or parent artery reva scularization and profound hypothermic circulatory arrest.

【关键词】 巨大颅内动脉瘤手术
【Key words】 GiantIntracranialAneurysmSurgery
  • 【文献出处】 中华神经外科杂志 ,Chinese Journal of Neurosurgery , 编辑部邮箱 ,2004年01期
  • 【分类号】R739.4
  • 【被引频次】44
  • 【下载频次】231
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