中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2001年
1期
39-41
,共3页
杨华%凌锋%王大明%宋庆斌%李萌%张鸿祺%缪中荣%郝蔓春
楊華%凌鋒%王大明%宋慶斌%李萌%張鴻祺%繆中榮%郝蔓春
양화%릉봉%왕대명%송경빈%리맹%장홍기%무중영%학만춘
脑动脉瘤%栓塞,治疗性%显微外科手术%脑血管重建术%弹簧圈栓塞
腦動脈瘤%栓塞,治療性%顯微外科手術%腦血管重建術%彈簧圈栓塞
뇌동맥류%전새,치료성%현미외과수술%뇌혈관중건술%탄황권전새
目的比较显微外科与血管内治疗对多发性颅内动脉瘤(MIA)的治疗效果和并发症发生率的差别。方法回顾分析20例MIA(共46个动脉瘤),根据MIA所在部位的区域分级标准,Ⅰ级8例(占40%),Ⅱ级10例(占50%),Ⅲ级2(占10%)。级别越高者,多倾向于选择血管内治疗。结果显微外科手术组8例,共19个动脉瘤,18个镜下全部夹闭、1个没发现未夹闭。血管内治疗组8例,共17个动脉瘤,14个100%闭塞、1个90%以上闭塞、2个因动脉瘤小导管不能到位未治。颅内外血管搭桥加颈内动脉闭塞2例。未治2例。结论 MIA所在部位的区域分级有助于治疗方法的选择,对MIA多倾向于血管内治疗,必要时可2种方法联合应用。
目的比較顯微外科與血管內治療對多髮性顱內動脈瘤(MIA)的治療效果和併髮癥髮生率的差彆。方法迴顧分析20例MIA(共46箇動脈瘤),根據MIA所在部位的區域分級標準,Ⅰ級8例(佔40%),Ⅱ級10例(佔50%),Ⅲ級2(佔10%)。級彆越高者,多傾嚮于選擇血管內治療。結果顯微外科手術組8例,共19箇動脈瘤,18箇鏡下全部夾閉、1箇沒髮現未夾閉。血管內治療組8例,共17箇動脈瘤,14箇100%閉塞、1箇90%以上閉塞、2箇因動脈瘤小導管不能到位未治。顱內外血管搭橋加頸內動脈閉塞2例。未治2例。結論 MIA所在部位的區域分級有助于治療方法的選擇,對MIA多傾嚮于血管內治療,必要時可2種方法聯閤應用。
목적비교현미외과여혈관내치료대다발성로내동맥류(MIA)적치료효과화병발증발생솔적차별。방법회고분석20례MIA(공46개동맥류),근거MIA소재부위적구역분급표준,Ⅰ급8례(점40%),Ⅱ급10례(점50%),Ⅲ급2(점10%)。급별월고자,다경향우선택혈관내치료。결과현미외과수술조8례,공19개동맥류,18개경하전부협폐、1개몰발현미협폐。혈관내치료조8례,공17개동맥류,14개100%폐새、1개90%이상폐새、2개인동맥류소도관불능도위미치。로내외혈관탑교가경내동맥폐새2례。미치2례。결론 MIA소재부위적구역분급유조우치료방법적선택,대MIA다경향우혈관내치료,필요시가2충방법연합응용。
Objective To study the results of embolization with MDS or GDC coils in patients with multiple intracranial aneurysms (MIA). Methods We retrospectively studied 20 patients with MIA (46 aneurysms). According to our standard of zone classification, 8 patients belonged to grade Ⅰ (40%), 10 grade Ⅱ (50%), 2 grade Ⅲ (10%). MDS or GDC embolization was used for the treatment of high grade patients. Results In microsurgery group (8 patients), 18 aneurysms were eliminated and one untreated.In endovascular group (8 patients) 14 aneurysms were occluded, one was almost occluded (>90%), and 2 were untreated because of their small size. In EC-IC bypass + balloon occlusion of the internal carotid artery (2 patients), complete occlusion was achieved in 2 giant aneurysms, and 2 aneurysms were untreated. Conclusions Zone classification of MIA is helpful to select, treatment. We frefer to endovascular treatment for MIA or combined microsurgical and endovascular approaches if necessary.