颅内后循环动脉瘤显微外科直视下手术治疗(附12例报告)  

THE DIRECT MICROSURGERY OF POSTERIOR CIRCULATION INTRACRANIAL ANEURYSMS(A REPORT OF 12 CASES)

作　　者：唐渊[1] 张苓[1] 陈礼刚 尹华锦[1] 雷军[1] 董劲虎[1] 李定君[1] 

机构地区：[1]泸州医学院附属医院神经外科,四川泸州646000

出　　处：《泸州医学院学报》2009年第6期599-600,共2页Journal of Luzhou Medical College

摘　　要：目的:探讨颅内后循环动脉瘤的手术治疗。方法:后循环动脉瘤12例,基底动脉交叉处为6例,大脑后动脉为3例,小脑下前、下后动脉为2例,基底动脉为1例。其中Hunter-Hess分级,Ⅰ级4例,Ⅱ级2例,Ⅲ级2例,Ⅳ级1例,Ⅴ级1例。结果:12例患者,8例痊愈,2例轻度神经功能障碍,2例重残,1例死亡。结论:后循环动脉瘤,手术难度大,入路选择,术中脑保护,临时阻断载瘤动脉,合理处理动脉瘤,亚低温深低温停循环应用,才能取得好效果。Objective：To explore the clinical features, microsugical treatment stategy and therapeutic effect of posterior circulation intracranial aneurysms. Methods：Of the 12 aneurysms, 6 were at the tips of basilar artery, 3 in posterior cerebral artery, 1 in the basilar artery, 2 in the anterior and posterior inferior cerebellar artery. According to Hunter-Hess grade, of 11 patients when being admitted, 4 were in grade Ⅰ , 2 in grade Ⅱ, 2 in Ⅲ, 1 in Ⅳ, 1 in Ⅴ. The aneurysm neck was clipped successfully in 10 patients, 3 were clipped and reseeted, the angioplasty was performed in 1. Results： Of 12 patients, 8 returned to normal , 2 had mild neurological defect, 2 were severely disabled and 1 died . Conclusion：The microsurgery for intracranial aneurysms in the posterior circulation is very difficult; proper surgical approach, procedures of temporary occlusion of parent arteries, brain protection and hypothermic circulatory arrests should be used to achieve satisfactory result.

关 键 词：颅内动脉瘤 后循环 显微手术 血管临时阻断 脑保护 

分 类 号：R739.41[医药卫生—肿瘤]