摘要： 目的 探讨颅内外血管搭桥联合动脉瘤孤立术治疗颅内巨大型动脉瘤患者的有效性及长期预后。方法 回顾2006 年12 月-2010 年10 月因颅内巨大型动脉瘤而施行颅内外血管搭桥联合动脉瘤孤立术患者的临床经过，根据术后临床症状和影像学改善程度评价手术良好率、病死率和搭桥血管闭塞率，Glasgow 预后分级（GOS）标准评价患者近远期预后。结果 25 例颅内巨大型动脉瘤患者近期（出院时）疗效良好率（GOS 评分4 ~ 5 分）为56.00%（14/25）、不良率（GOS 评分1 ~ 3 分）44.00%（11/25），手术相关病死率8.00%（2/25），血管闭塞率12.00%（3/25）；远期（随访期间）疗效良好率（GOS 评分4 ~ 5 分）78.95%（15/19），不良率（GOS 评分1 ~ 3 分）21.05%（4/19），病死率15.79%（3/19），搭桥血管闭塞率10.53%（2/19）。结论 颅内外动脉血管搭桥联合动脉瘤孤立术是治疗颅内巨大型动脉瘤的有效方法。

关键词: 颅内动脉瘤, 脑血管重建术, 荧光素血管造影术

Abstract: Objective To evaluate the therapeutic effect and follow-up outcomes of extracranial-intracranial revascularization in giant intracranial aneurysms. Methods The therapeutic effect and outcomes of bypass surgery in the treatment for 25 patients with giant intracranial aneurysms (Dec. 2006 to Oct. 2010) were analysed. The favorable rate [Glasgow Outcome Scale (GOS)], occlusion rate and mortality were evaluated. Results The favorable rate (GOS 4-5) was 56.00% (14/25), unfavorable rate (GOS 1-3) was 44.00% (11/25), morbidity was 8.00% (2/25), and occlusion rate was 12.00% (3/25). When followed up on Otc. 2011, effective rate (GOS 4-5) was 78.95% (15/19), the unfavorable rate (GOS 1-3) was 5.26% (1/19), morbidity was 15.79% (3/19), and occlusion rate was 10.53% (2/19). Conclusion The extracranial-intracranial revascularization is effective in the treatment for giant intracranial aneurysms.

Key words: Intracranial aneurysm, Cerebral revascularization, Fluorescein angiography