摘要
目的探讨经翼点入路夹闭60例前交通动脉瘤的显微外科手术技巧。方法回顾性分析手术治疗60例前交通动脉瘤的临床表现、影像学资料及手术。结果术前DSA能清楚显示动脉瘤的大小、形状以及A1优势征的影像学表现。60例患者中出院时按GOS评分分为恢复良好者51例,中残3例,重残4例,死亡2例。结论大脑前动脉A1段发育不全与前交通动脉瘤的发生有较高的相关性;早期(3d内)行手术夹闭前交通动脉瘤能防止因动脉瘤再次破裂引起的直接死亡和病情恶化;熟练掌握显微外科手术技巧以及术中出现动脉瘤破裂时正确的处理方法,对提高手术成功率至关重要;术中清除脑池内积血,采用罂粟碱灌洗脑池,能减轻脑血管痉挛,改善预后。
Objective To explore the operative techniques and experience in 60 cases of anterior communicating artery （ACoA） aneurysms treated with microsurgery via pterional approach. Methods 60 patients with ACoA aneurysms underwent microsurgery through pterional approach. The clinical manifestations, angiograms, and surgical operation were retrospectively analyzed. Results Preoperative digital subtraction angiography （DSA） could identify the size and shape of the AcoA aneurysms, as well as the A1 dominant signs character. Among the 60 cases with AcoA aneurysms that were all successfully occluded, 51 patients were discharged in good condition, 3 patients suffered from moderate disability, 4 were in severe disability and 2 died. Conclusion There is a close relationship between hypoplasia of A1 segments and AcoA aneurysms. Early clipping of AcoA aneurysms （within 3 days） can prevent death and deterioration of condition caused by aneurysmal re-rupture. To master the microsurgical techniques and use correct treatment while aneurysm is ruptured during operation, it is important to elevate the operation achievement ratio. To clear up haematocele in the cistern and use the papaverine to wash the cistern during operation, it can relieve the secondary cerebral vasospasm, and improving the prognosis of patients.
出处
《中华神经外科杂志》
CSCD
北大核心
2007年第12期910-913,共4页
Chinese Journal of Neurosurgery
基金
江苏省135医学重点科学基金资助项目
苏卫教(2003)19号
