翼点入路前交通动脉瘤显微手术的疗效分析
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摘要
目的探讨前交通动脉瘤的手术技巧及术后并发症的预防。。方法回顾性分析25例行翼点入路前交通动脉瘤夹闭术患者的临床资料,对患者的预后进行统计学分析。结果本组病人共计25例,23例行动脉瘤夹闭术,2例行载瘤动脉孤立夹闭术,出院时预后良好者19例,中残者2例,重残者1例,放弃治疗1例,死亡2例。结论翼点入路前交通动脉瘤显微手术是治疗的有效手段,术中充分显露与阻断、术后积极处理并发症能够明显改善病人预后。
Objective To explore the surgical technique of anterior communicating aneurysm and the prevention of postoperative complications. Methods The clinical data of 25 patients who were treated with anterior communicating aneurysm clipping via pterional approach were analyzed retrospectively and the prognosis was statistically analyzed. Results There were 25 cases being analyzed. Among them, 23 cases underwent incarceration of aneurysm, 2 cases were performed with isolated aneurysmal occlusion. The prognosis at discharge was good in 19 cases, middle disability in 2 cases, severe disability in 1 case, abandonment of treatment in 1 case and death in 2 cases. Conclusions Microsurgical treatment of anterior communicating aneurysm via pterion approach is an effective method. Full exposure and occlusion during operation and active management of postoperative complications can significantly improve the prognosis of patients.
Objective To explore the surgical technique of anterior communicating aneurysm and the prevention of postoperative complications. Methods The clinical data of 25 patients who were treated with anterior communicating aneurysm clipping via pterional approach were analyzed retrospectively and the prognosis was statistically analyzed. Results There were 25 cases being analyzed. Among them, 23 cases underwent incarceration of aneurysm, 2 cases were performed with isolated aneurysmal occlusion. The prognosis at discharge was good in 19 cases, middle disability in 2 cases, severe disability in 1 case, abandonment of treatment in 1 case and death in 2 cases. Conclusions Microsurgical treatment of anterior communicating aneurysm via pterion approach is an effective method. Full exposure and occlusion during operation and active management of postoperative complications can significantly improve the prognosis of patients.
引文
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[11]吴红星,吴永刚,帕尔哈提?热西提,杨小朋.颅内动脉瘤的显微外科治疗(附112例报告)[J].新疆医学,2010,40(06):30-31.
[12]帕尔哈提·热西提,吴红星,刘伟,乌拉别克,杨小朋.颅内多发动脉瘤的显微外科治疗(附7例分析)[J].新疆医学,2012,42(04):5-7.
[2]邱传亚,张勇,薛彩霞,等.成年健康男性大脑前动脉A1段变异者Willis环形态的MR血管成像研究[J].中华放射学杂志,2014,48:897-901.
[3]Yasargil MG.Microneurosurgery[M].VolⅡ.New York:Georg Thieme Verlag,1984,33-229
[4]Iwanaga H,Wakai S,Ochiai C,et al.Ruptured cerebral anerysms missed by initial angiographic study[J].Neurosurgery,1990 27:45-51.
[5]高振文刘天庆,等.Hunt-HessⅣ级前交通动脉瘤早期手术疗效分析[J].立体定向和功能性神经外科杂志,2016,29(1)38~41.
[6]Heiskanen O,Poranen A,KuurneT,et al.Acute surgery for intracerebral haematomas caused by rupture of an intracranial arterial aneurysm.A prospective randomized study[J].Acta Neurochir(Wien),1988,90(3/4):81-83.
[7]詹仁雅,主译.神经外科手术技术图谱[M].山东:山东科学技术出版社,2012:148-149
[8]王任直,主译.尤曼斯神经外科学[M].VolⅡ..北京:人民卫生出版社,2009:1544-1545
[9]Ljunggren B,Sonesson B,Saveland H,Brandt L:Cognitive impairment and adjustment in patients without neurological deficits afer aneurismal SAH and early operation.[J].Neurosurg 1985,62:673-679.
[10]丁璇,王志刚,王成伟,等.不同治疗方式对高分级动脉瘤性蛛网膜下腔出血患者预后的影响[J].中华医学杂志2012,92(43)3054-3057.
[11]吴红星,吴永刚,帕尔哈提?热西提,杨小朋.颅内动脉瘤的显微外科治疗(附112例报告)[J].新疆医学,2010,40(06):30-31.
[12]帕尔哈提·热西提,吴红星,刘伟,乌拉别克,杨小朋.颅内多发动脉瘤的显微外科治疗(附7例分析)[J].新疆医学,2012,42(04):5-7.