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目的探讨颅内动脉瘤的外科治疗方法及手术时机。方法颅内动脉瘤148例,94例开颅显微镜下夹闭手术,54例行血管内栓塞术。结果术后死亡8例。随访134例5~36个月,108例恢复良好,10例偏瘫,5例动眼神经麻痹,2例癫痫。1例植物生存,2例患者复发再次手术。结论 Hunt-Hess I级~Ⅲ级的患者显微外科手术与血管内介入栓塞疗效相似,并发症发生率接近,应选择术者最熟练,操作最简单的治疗方式。Hunt-HessⅣ级、V级患者,尽早血管内治疗效果较好。
Objective To investigate the surgical treatment of intracranial aneurysms and the timing of surgery. Methods 148 cases of intracranial aneurysms, 94 cases craniotomy under the clamp operation, 54 cases of endovascular embolization. Results Postoperative death in 8 cases. Follow-up 134 cases 5 to 36 months, 108 cases recovered well, 10 cases of hemiplegia, 5 cases of oculomotor nerve paralysis, 2 cases of epilepsy. One patient survived and two patients relapsed and reoperated. Conclusion The results of microsurgery and endovascular embolization in patients with Hunt-Hess class I-III are similar. The incidence of complications is similar, and the most skilled and the simplest mode of operation should be selected. Hunt-Hess Ⅳ level, V-class patients, as soon as possible endovascular treatment is better.