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目的探讨显微手术与血管内栓塞治疗颅内动脉瘤的效果、特点、适应证及治疗原则。方法回顾性分析应用显微手术治疗的202例颅内动脉瘤患者与经血管内介入治疗的56例颅内动脉瘤患者的临床资料。结果术后按GOS评分评定手术疗效,经显微手术治疗的202例中,术后恢复良好132例,中残38例,重残21例,死亡11例。经血管内介入治疗的56例61个动脉瘤中,54个动脉瘤行可脱性弹簧圈栓塞,1个行单纯支架置入,6个行支架置入+可脱性弹簧圈栓塞;术后恢复良好35例,中残11例,重残8例,死亡2例。结论显微手术与血管内栓塞治疗颅内动脉瘤各有其特点及适应证。根据动脉瘤的大小、部位、术者经验选择不同的手术方式,均能取得满意效果。
Objective To investigate the effect, characteristics, indications and treatment principles of intracranial aneurysm treated by microsurgery and endovascular embolization. Methods The clinical data of 202 patients with intracranial aneurysm treated by microsurgery and 56 patients with intracranial aneurysm treated by endovascular interventional therapy were retrospectively analyzed. Results According to the GOS score, the curative effect was evaluated. Among the 202 cases treated by microsurgery, 132 cases recovered well, 38 cases were moderate disability, 21 cases were severe disability and 11 cases died. Among the 61 aneurysms treated by endovascular intervention, 54 aneurysms were embolized with detachable coils, one was implanted with simple stents, and the other 6 stents were implanted with detachable coils. After operation There were 35 cases recovered well, 11 cases were moderate disability, 8 cases were severe disability and 2 cases died. Conclusion Microsurgery and intravascular embolization have their own characteristics and indications for the treatment of intracranial aneurysms. According to the size of the aneurysm, site, surgery experience choose a different surgical approach, can achieve satisfactory results.