摘要
目的 对颅内动脉瘤的局部解剖有更全面的了解 ,探讨内窥镜与手术显微镜结合治疗颅内动脉瘤的可行性及其意义。方法 对 2 3例颅内动脉瘤病人 ,2 6个颅内动脉瘤应用内窥镜辅助手术显微镜进行颅内动脉瘤夹闭术。应用手术显微镜初步显露动脉瘤后 ,置入硬性神经内窥镜了解动脉瘤颈及周围结构的局部解剖 ,动脉瘤夹闭后再次用内窥镜了解夹闭情况。结果 术后 19例恢复良好。2例后循环动脉瘤及 1例颈内 后交通动脉瘤出现暂时性动眼神经麻痹。 1例前交通动脉瘤术后脑积水 ,另 1例多发动脉瘤术后由于血管痉挛脑缺血出现右侧肢体不完全性瘫痪。术后并发症与应用神经内窥镜无关。结论 应用硬性神经内窥镜辅助颅内动脉瘤显微手术 ,可明显增加动脉瘤及其周围结构的可视范围 ,使颅内动脉瘤的手术效果有明显提高。
Objective To enhance visual confirmation of regional anatomy and discuss the feasibility and the role of combining the neuroendoscope with the surgical microscope in order to treat intracranial aneurysms. The endoscope was introduced during microsurgery for cerebral aneurysms. Methods The neuroendoscope was used to assist surgical microscope to treat 26 intracranial aneurysms in 23 patients. After initial exposure with the aid of a microscope, the rigid endoscope was introduced to confirm the regional anatomy, including the aneurysm neck and adjacent stuctures. After clipping, the positions of the clip and nearby stuctures were inspected by using of neuroendoscope. Results After operations, 19 cases were recovered without any severe complications. A transient oculomotor nerve paralysis appeared in 2 cases with posterior circulation aneurysms and in 1 case with ICA PCoA aneurysm. There was 1 case with hydrocephalus and 1 case with incomplete paralysis of the right extremities, due to cerebral vasospasm and ischemia. No complications related with the use of endoscope occured in any of our patients. Conclusion In all cases when the endoscope was used,there was a striking improvement in the visualisation of the aneurysm and its surrounding structures in all cases. Furthermore, the position and the state of the parent artery of the aneurysm could be easily examined, therefore, the operative effect could be greatly improved.
出处
《中华神经外科杂志》
CSCD
北大核心
2000年第1期8-10,共3页
Chinese Journal of Neurosurgery
