【摘要】 目的探讨破裂的大脑中动脉动脉瘤的临床特点、治疗技术及其疗效。方法 139例破裂的单纯性大脑中动脉动脉瘤患者中,采用显微手术治疗107例,血管内治疗32例。结果血管内治疗组动脉瘤100%闭塞的27例,95%闭塞的3例,90%闭塞的2例。显微手术组中,4例包裹,2例行孤立术,其余均成功夹闭。根据GOS评估预后:Ⅰ级(死亡)7例,Ⅱ级(植物生存)2例,Ⅲ级(重残)21例,Ⅳ级(中残)17例,Ⅴ级(恢复良好)92例。结论对Hunt-HessⅠ～Ⅲ级破裂的大脑中动脉动脉瘤患者行显微手术或血管内治疗效果可靠;根据不同病情,选择合理的治疗手段、有效的术后处理能改善破裂性大脑中动脉动脉瘤患者的预后。更多还原

【Abstract】 Objective To explore the clinical characteristics and surgical technique of the middle cerebral artery aneurysms(MCAA) and the curative effect on MCAA.Methods Of 139 patients with MCAA,107 underwent microsurgery and 32 endovascular treatment.Results Of 32 patients with MCAA undergoing endovascular treatment,27 received the occlusion of 100% aneurismal cavities,3 did 95% and 2 did 90%.Of 107 patients with MCCA undergoing the microsurgery,4 received wrapping of aneurysms,2 trapping and 101 successful clipping.Of 139 patients with MCAA,92 were recovered well,17 moderately disabled,21 severely disabled,2 vegetatively survived and 17 died according GOS after the treatment.Conclusions The curative effects of the microsurgery and endovascular treatment on MCAA are good in the patients with Hunt-Hess grades Ⅰ Ⅲ.The prognoses can be improved by the reasonable treatment and positive postoperative treatment in the patients with MACC.更多还原