目的：探讨颈内动脉血泡样动脉瘤（blood blister-like aneurysm，BBA）的临床特点、手术技巧及效果。方法回顾性分析从2006年1月至2016年1月十年间我科手术治疗的45例BBA患者的临床资料，并对结果进行分析总结。结果手术直接夹闭38例，夹闭加包裹3例，孤立4例。手术中发生破裂12例（27%）,术后10例发生脑梗死（22%），手术死亡7例（16%）。术后对38例存活患者进行长期随访，随访6～126个月（平均46月个），改良Rankin（modified Rankin Scale，mRS）评分：0～2分34例（76%），3～5分4例。影像学随访1例复发，给予介入栓塞治疗。所有患者随访期间均未出现再出血。结论颈内动脉BBA处理困难，手术具有很高的风险及并发症。术前充分的认识以及术中多种手术策略的运用，可以降低手术的风险，取得满意的疗效。%Objective To explore the clinical features, surgical techniques and treatment efficacy of blood blis⁃ter-like aneurysms (BBA) of the internal carotid artery (ICA). Method We retrospectively reviewed 45 BBAs of the ICA treated surgically at our department between Jan. 2006 and Jan. 2016. The data was analyzed. Results Direct clipping of BBA was performed in 38 patients, clipping over wrapping in 3 patients and trapping of ICA in 4 patients. Intraoperative rupture occurred in 12 patients (27%). Postoperative cerebral infarction developed in 10 cases (22%). Seven patients died (16%). During the follow-up time of 47 months (range, 6~126 months), Good results were achieved in 34 patients (76%) with a modified Rankin Scale (mRS) 0~2 and 4 patients were in mRS 3~5. Follow-up angiography revealed a re⁃currence of BBA in one patient, which was retreated with endovascular coiling. No rebleeding was found in all fol⁃lowed-up patients. Conclusions BBAs of the ICA are difficult to treat surgically with high risk and complications. Thoughtful pre-operative evaluation of BBA and application of various surgical strategies during operation can signifi⁃cantly reduce the surgical risk and achieve good outcomes.
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