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颅内巨大动脉瘤的手术治疗
Surgical treatment intracranial aneurysms of giant
【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.
- 【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