摘要
目的探讨颅内前循环动脉瘤的显微外科手术治疗效果。方法回顾43例前循环动脉瘤患者的临床资料,其中单纯蛛网膜下腔出血32例,蛛网膜下腔出血伴血肿7例,蛛网膜下腔出血伴动眼神经麻痹2例,意外发现2例,多发动脉瘤3例,共46个。大型6例,中型14例,小型23例。前交通8枚,后交通23枚,大脑中动脉9枚,颈内动6枚。急诊手术7例,5d内手术28例,15d后手术8例。结果成功夹闭动脉瘤43例,术中发生动脉瘤破裂2例,阻断载瘤动脉后夹闭动脉瘤。按照GOS预后评分,4~5分30例,2~3分6例,死亡4例,植物生存3例,术后出现脑积水3例,行脑室腹腔分流。结论在基层医院具有显微技术及血管成像技术后,开展动脉瘤夹闭术是可行的,可以为基层患者提供满意的治疗效果。
Objective To investigate the efficacy of microsurgery for intracranial anterior circulation aneurysms in primary hospital. Methods The clinical data of 43 patients were retrospectively reviewed. Among those 43 patients, there were 32 cases of subarachnoid hemorrhage, 7 cases of subarachnoid hemorrhage with hematoma, 2 cases of subarachnoid hemorrhage with oculomo- tor nerve paralysis,2 cases of unexpected discovery and 3 cases of multiple aneurysms. There were 6 cases of large aneurysms, 14 medium aneurysms and 23 small aneurysms. 8 cases were suited anterior communicating artery, 23 cases in posterior communica- ting arteries, 9 cases in middle cerebral arteries and 6 cases in internal carotid arteries. Emergency operation was performed in 7 ca- ses,operation in five days in 28 cases and operation after half month in 8 cases. Results Total aneurysm clipping was achieved in 43 cases. 2 cases had aneurysm rupturing during the operation. We clipped the aneurysm after blocking the artery. According to the GOS prognostic score, 4-5 score was in 30 cases, 2-3 score in 6 cases, death in 4 cases, vegetative state in 3 cases and hydrocephalus in 3 cases （accepting ventriculoperitoneal shunt）. Conclusion It is feasible to carry out clipping of aneurysm with microsurgical technique and vascular imaging technique in primary hospital. It can provide satisfactory therapeutic effect for the patients in pri- mary hospital.
出处
《中国实用神经疾病杂志》
2017年第23期90-92,共3页
Chinese Journal of Practical Nervous Diseases
基金
河南省县级重点专科项目(2015)
关键词
前循环动脉瘤
开颅夹闭术
显微手术
血管成像
蛛网膜下腔出血
脑卒中
Intracranial anterior circulation aneurysms
Craniotomy clipping
Microsurgery
Vascular imaging
Subarachnoidhemorrhage
Srtoke
