摘要 目的：探讨椎-基底动脉瘤治疗方法与预后关系。材料与方法：报告33例椎-基底动脉瘤。动脉瘤破裂致SAH 18例，动脉瘤直径从5mm到45mm。其中9例行保守治疗。直接手术治疗中，9例夹闭术，2例瘤壁加固术。13例行血管内栓塞治疗。结果：9例保守治疗中3例因再次出血死亡。11例直接手术均痊愈。13例血管内栓塞治疗后1～3个月后复查造影，闭塞率>80%者12例。结论：椎-基底动脉瘤积极手术治疗可降低死亡率，依动脉瘤部位与大小采用不同手术入路至关重要，血管内栓塞治疗适于直接手术难以达到者，疗效肯定。

    The clinical review of vertebral-basilar artery aneurysm in 33 cases Zhi Dashi, Jiao Derang, Yang Yushan, et al. Dept, of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300060

    Abstract Objective: To study the relationship between treatment and prognosis of vertebral-basilar artery aneurysm. Methods: Thirty-three cases of vertebral-basilar aneurysm located at basilar artery trunk, bifurcation, middle and inferior parts of basilar artery or vertebral artery were reported. There were 18 cases of SAH due to rupture of aneurysm which the diameters in size ranged from 5 to 45mm. Among 33 cases, 9 cases were treated conservatively, 11 cases were operated with clipping or wrapping of aneurysm respectively 13 cases were treated with endovascular therapy. Results: 3 patients in conservative group died from further hemorrhage and 11 patients in the operative group were recovered completely. The emboric rate in 12 patients of 13 cases documented by angiography 1～3 months after operation was larger than 80% in the endovascular therapy group. Conclusion: It is very important to select different approach according to the location and size of aneurysm. Although the operation can obviously decrease mortality of vertebral-basilar artery aneurysm. The endovascular therapy may be useful for the aneurysm that treate difficult with direct operation.

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