脑前循环系统动脉瘤的外科治疗  

Microsurgical treatment of anterior circulation aneurysms

作　　者：李善泉[1] 罗其中[2] 熊文浩[1] 郭尚志[1] 王勇[1] 徐纪文[1] 邱永明[1] 郑彦[1] 殷玉华[1] 李骁雄[1] 费智敏[1] 潘耀华[1] 万杰青[1] 

机构地区：[1]上海第二医科大学仁济医院神经外科 [2]上海第二医科大学仁济医院神经外科上海200001

出　　处：《微侵袭神经外科杂志》1997年第1期18-20,73-74,共3页

摘　　要：本文报告113例脑前循环系统动脉管其中包括颈内动脉后交通动脉瘤75例.前交通动脉瘤17例,大脑中动脉瘤10例,人脑前动脉-胼周动脉瘤3例,颈内动脉-眼动脉瘤2例,颈内动脉海绵窦段动脉瘤1例.多发动脉瘤5例.共118个动脉瘤在显微镜下直视手术,动脉瘤直接夹闭术108例.孤立或包裹术5例:5例多发动脉瘤行同期手术3例,分期手术2例.术中发生动脉瘤破裂18次.Hunt和HessⅠ～Ⅱ级病人中有例行早期手术.全组术后死亡率为7.9%.着重讨论手术时机.术中动脉瘤破裂处理及多发动脉瘤的治疗.One hundred and thirteen cases of anterior circulation aneurysms treated by microsur-gical operation were reported, which included 75 ICA-PCoA aneurysms, 17 ACoA aneurysms, 10 MCA aneurysms, 3 ACA aneurysms, 2 ICA-OPhA aneurysms,1 intracavernous carotid artery aneurysm, and 5 multiple aneurysms (2 a-neurysms each). All the aneurysms were treated microsurgically:clipping of neck in 108, trapping or wrapping in 5, and the 5 cases of multiple a-neurysms were operated by one or two staged op-erations. Intraoperative aneurysm rupture oc-cured in 18 cases. 2 patients of Hunt and Hess grade Ⅰ - Ⅱ were treated early within 48 hours after initial bleeding. The timing of operation, management of intraoperative rupture of a-neurysm and the treatment of multiple a-neurysms were discussed.

关 键 词：脑前循环系统 动脉瘤 治疗 外科手术 

分 类 号：R739.41[医药卫生—肿瘤]