翼点锁孔入路显微手术治疗颅内前循环动脉瘤  

Microsurgical treatment of the anterior circulation aneurysms with pterional keyhole approach

作　　者：康德智[1] 兰青[2] 林元相[1] 余良宏[1] 林章雅[1] 吴赞艺[1] 

机构地区：[1]福建医科大学附属第一医院神经外科,福州350005 [2]苏州大学附属第二医院神经外科,苏州215004

出　　处：《中华神经医学杂志》2006年第2期165-168,共4页Chinese Journal of Neuromedicine

基　　金：江苏省科技厅基金资助项目(BS2002017)

摘　　要：目的介绍一种颅内动脉瘤微创手术治疗的入路和方法。方法对34例颅内前循环动脉瘤均采用一侧翼点锁孔入路,以直径约2cm×2.5cm的骨窗行显微外科手术治疗。结果34例患者共36个动脉瘤均一次夹闭成功。根据GOS评估标准,恢复良好者29例,轻残4例,死亡1例。所有手术无术后感染、出血及脑脊液漏等手术并发症。结论采用翼点锁孔入路治疗颅内动脉瘤,手术损伤小,并发症少,患者恢复良好,是一种损伤小、安全而有效的手术治疗方法。Objective To introduce an surgical approach and means for invasive surgical treatment of intracranial aneurysms. Methods The unilateral pterional keyhole approach with a 2 cm ×2.5 cm surgical bone window was used in the microsurgery of 34 anterior circulation aneurysms. Results There were 34 patients with 36 aneurysms, including 6 middle cerebral artery aneurysms, 2 anterior cerebral artery aneurysms, 15 anterior communicating artery aneurysms, 5 posterior communicating artery aneurysms, 1 ophthalmic artery aneurysm and 7 internal carotid artery Aneurysms. All aneurysms were clipped successfully in one operation by unilateral pterional keyhole approach. Outcome was considered according to GOS as good recovery in 29 cases, mild disability in 4 cases and death in 1 case. There was no infection, bleeding or cerebrospinal fluid leakage after operations. Conclusion The pterional keyhole craniotomy and the microsurgical technique can reduce iatrogenic trauma and complications, and promote recovery. For an experienced neurosurgeon, the pterional keyhole approach may produce minute injury, effective and safe for the treatment of intracranial aneurysms.

关 键 词：脑动脉瘤 显微外科手术 翼点入路 锁孔入路 

分 类 号：R739.4[医药卫生—肿瘤]