【摘要】 目的总结53例颅内多发动脉瘤(MIA)外科治疗的经验。方法回顾性分析53例MIA患者的临床资料,探讨影响其预后的因素,总结手术相关的注意点和技巧。结果 53例中,介入治疗17例,手术治疗36例。共处理动脉瘤128个;其中,一期夹闭或栓塞94个,其余的予以包裹加固或姑息观察处理。GOS评分预后良好37例,差16例。单因素分析显示,术前Hunt-Hess分级与预后密切相关(P<0.05)。多因素Logistic回归分析显示,Hunt-Hess分级、动脉瘤数量和采取外科干预的时间与患者预后相关(P<0.05)。结论 Hunt-Hess分级显著影响颅内多发动脉瘤患者的预后,充分的术前评估和采取合适的治疗方案有助于患者恢复。更多还原

【Abstract】 Objective To summarize the experience in surgical treatment of 53 cases with multiple intracranial aneurysms(MIA).Methods The data of 53 patients with MIA were retrospectively analyzed.The factors influencing the prognosis were analyzed and surgical techniques were summarized.Results Of 53 patients,occlusion with clip was performed in 36 cases and interventional embolization was carried out in 17 cases.Glasgow outcome scale showed favorable(4-5grades)in 37 cases and or unfavorable(1-3grades)in 16 cases.Univariable analysis showed that Hunt-Hess grade was the only predictor for the outcomes(P<0.05).Multiple Logistic regression analysis showed that the preoperative Hunt-Hess grades,the number of the aneurysms and the timing of surgical treatment were the factors closely related to the outcomes(P<0.05).Conclusion The Hunt-Hess grade has significant influence on the prognosis of patients with MIA.Sufficient preoperative evaluation and appropriate selection of treatment are helpful in improving the prognosis of patients with MIA.更多还原