前交通动脉动脉瘤的分型及其显微手术治疗  

Classification and microsurgical treatment of anterior communicating artery aneurysms

作　　者：王雷[1] 田道锋[1] 陈治标[1] 徐海涛[1] 黄书岚[1] 蔡强[1] 吴立权[1] 陈谦学[1] 

机构地区：[1]武汉大学人民医院神经外科,430060

出　　处：《中国临床神经外科杂志》2011年第5期257-259,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨前交通动脉(ACoA)动脉瘤的临床分型及其显微手术治疗。方法回顾性分析2007年7月至2010年4月显微手术夹闭的154例ACoA动脉瘤患者的临床资料,根据瘤顶指向将动脉瘤分为指向前方型、指向上方型、指向后方型、指向下方型和复杂指向型共五型。结果出院时按GOS评分,预后良好(GOS4～5分)134例(87.01%),差(2～3分)12例(7.79%),死亡(1分)8例(5.19%)。146例患者术后随访6个月～3年,无再出血及死亡病例。结论 ACoA动脉瘤瘤顶指向复杂多变,根据其瘤顶指向类型进行个体化手术治疗有利于提高患者生存率和生活质量。Objective To investigate the clinical classification and microsurgical treatment strategy of anterior communicating artery （ACoA） aneurysms.Method The clinical data of 154 patients with 159 ACoA aneurysms,who were treated by microsurgery in our department from July,2007 to April,2010,were analyzed retrospectively.Results According to the directions of the aneurysmal tops projection,one hundred and fifty-nine aneurysms were divided into 5 types including forward types （33 aneurysms,20.8%）,upward type （41,25.8%）,backward type （35,22.0%）,downward type （27,17.0%） and complex type （23,14.5%）.According to GOS,of 154 patients with ACoA aneurysms,134 were recovered well （GOS,4～5 points）,12 bad （GOS,2～3 points） and 8 died.Conclusions The directions of the aneurysmal tops projection are complex and varied.The curative effect of microsurgery on the patients with ACoA aneurysms can be improved by the individualized treatment plan which is developed according the directions of ACoA anuerysmal tops projection.

关 键 词：前交通动脉动脉瘤 显微手术 分型 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]