中国未破裂颅内动脉瘤临床管理指南（2024版）

·1918·中华医学杂志2024年6月4日第104卷第21期Natl Med J Chir,Jne4.2024,Val.104.No.21·标准与规范·中国未破裂颅内动脉瘤临床管理指南(2024版)中华医学会神经外科学分会中国卒中学会脑血管外科分会国家神经系统疾病医学中心国家神经系统疾病临床研究中心通信作者：王硕，首都医科大学附属北京天坛医院神经外科，北京100070，Email:captain9858@vip.sina.com;赵继宗，国家神经系统疾病临床研究中心，北京100070，Email:zhaojz205@163.com;赵兵，上海交通大学医学院附属仁济医院神经外科，上海200127,Email:zhaobing@renji.com【摘要】未破裂颅内动脉瘤(UA)在我国35~75岁成人中的患病率约7%。随着人口老龄化趋势，UA检出率增加。大多数U1A是偶然发现的，通常无症状，选择手术治疗还是保守治疗一直存在争议。尽管A的年破裂风险低，但一旦发生破裂，其致死率和致残率高。本临床管理指南基于循证证据，围绕UA的人群筛查、临床影像诊断、生长破裂风险评估、治疗策略及选择、术后随访和特殊人群UI管理建议等方面，共形成44条推荐意见，旨在为临床医师、其他相关专业人员提供实用的临床指导建议。【关键词】颅内动脉瘤；流行病学；破裂风险因素；临床管理；治疗：预后：指南基金项目：国家重点研发计划(2021Y℃2501100)实践指南注册：国际实践指南注册与透明化平台(PREPARE-2023CN191)Chinese guideline for the clinical management of patients with unruptured intracranialaneurysms (2024)Society of Neurosurgery of Chinese Medical Association,Society of Cerebrovascular Surgery of ChineseStroke Association,National Center for Neurological Disorders,National Clinical Research Center forNeurological DiseasesCorresponding authors:Wang Shuo,Department of Neurosurgery,Beijing Tiantan Hospital,CapitalMedical University,Beijing 100070,China,Email:captain9858@vip.sina.com;Zhao Jizong,ChineseNational Clinical Research Center for Neurological Diseases,Beijing 100070,China,Email:zhaojz205@163.com:Zhao Bing,Department of Neurosurgery,Renji Hospital,School of Medicine,Shanghai JiaoTong University,Shanghai 200127,China,Email:zhaobing @renji.comAbstract)Unruptured intracranial aneurysm (UIA)has an estimated prevalence of about7%among adults aged 35-75 in China.With the aging population trend,the detection rate of UIA isincreasing.Most UIA are incidentally discovered and typically asymptomatic.There has beenongoing debate regarding the choice between aggressive treatment and conservative management.Although UIA has a low annual risk of rupture,once rupture occurs,the mortality and disability ratesare high.Based on evidence-based medicine,this clinical management guideline provides 44recommendations on population screening,clinical imaging diagnosis,risk assessment of growthand rupture,treatment strategies and selection,postoperative follow-up,and management of specialD01:10.3760/cma.j.cm112137-20240222-00373收稿日期2024-02-22本文编辑朱蹈引用本文：中华医学会神经外科学分会，中国卒中学会脑血管外科分会，国家神经系统疾病医学中心等.中国未破裂颅内动脉瘤临床管理指南(2024版)中华医学杂志，2024,10421k1918-1939.D01:10.3760/emaj.cn112137-20240222-00373