摘要
目的探讨采用“低位额部锁孔经纵裂入路”处理前交通动脉瘤的手术方法。方法沿发际前缘自然走行横行切开5cm,或取额部一较深的额纹,横行切开皮肤。在眉间上2.5cm处,铣一中线偏右侧的3cm×3.5cm游离小骨瓣。牵开右侧额叶和A2段,沿胼胝体膝部前缘到达前交通动脉。分离动脉瘤颈后选择合适的动脉瘤夹夹闭。结果18例病人中,术前Hunt分级Ⅰ级6例,Ⅱ级8例,Ⅲ级2例,Ⅳ级2例。术后恢复良好15例,迁延性昏迷1例,偏瘫1例,死亡1例。5例术后行DSA复查,无残留瘤颈。结论微创锁孔小骨窗行动脉瘤夹闭术是安全可行的,术者应对鞍上胼胝体区的显微解剖十分熟悉。
Objective To investigate a low anterior interhemispheric″key-hole″approach with minimal invasion to clip the aneurysms of anterior communicating artery.Method A horizontal skin incision along anterior border of hair-trace was made with about 5-6cm.After arriving AcoA along genu of corpus callosum,neck of aneurysm was dissociated and clipped with a suitable clip.Result On preoperative clinical staging,according to the Hunt and Hess scale,6patients were belong to0toⅠstage,8belong to stage II,2belong to stage III and2belong to stage IV.Recovery were excellent at15patients,persisting coma at1,hemiplegia at1.1patient was dead of pulmonary infection.Postoperative DSA were performed at5patients and no retained neck of aneurysm was found.Conclusion Using of minimally invasive procedure as a″key-hole″is possible,safe and aesthetic method.Neurosurgeons must know well about the microanatomy of the pericallosal arterial complex region.
出处
《中国微侵袭神经外科杂志》
CAS
2002年第2期73-75,共3页
Chinese Journal of Minimally Invasive Neurosurgery
