颅内囊性动脉瘤显微手术疗效观察(附20例报告)  

Observation of curative effect of microsurgery on intracranial saccular aneurysms (report of 20 cases)

作　　者：张文建 王建 

机构地区：[1]晋城心脑血管病医院神经外科,山西048000

出　　处：《中国临床神经外科杂志》2011年第6期333-334,352,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨颅内动脉瘤的临床特点、手术适应证、手术入路和治疗效果。方法回顾性分析20例经显微手术治疗的颅内囊性动脉瘤患者的临床资料。结果 20例患者有23个动脉瘤,完全夹闭21个,包裹1个,不全夹闭加包裹1个。1例患者术后10天发生脑积水进行了分流手术;2例后循环动脉瘤患者中,1例单侧动眼神经麻痹及1例双侧动眼神经麻痹均在术后1个月内恢复。出院时按GOS评定预后,良好12例,轻残7例,死亡1例。结论选择适当时机,利用合适入路的显微外科技术夹闭动脉瘤效果较好。术后用高血压、高灌注、高血容量等治疗能有效防治脑血管痉挛,改善经手术治疗后动脉瘤患者的预后。Objective To explore clinical features,surgical indication,surgical approach of the intracranial aneurysms and curative effect of microsurgery on them.Method The clinical data of 20 patients with intracranial secular aneurysms undergoing microsurgery from 2008 to 2010 were analyzed retrospectively.Results Of 23 aneurysms in 20 patients,21 were successfully clipped,1 wrapped and 1 clipped and wrapped.The shunt was performed in 1 patient with hydrocephalus occurring 10 days after the operation.Two patients with posterior circulation aneurysms were perfectly recovered from the unilateral or bilateral oculomotor never palsy 1 month after the operation.Of 20 patients,12 were recovered very well,7 mildly disabled and 1 died.Conclusions The curative effect of microsurgery through the appropriate approach which is performed at the appropriate time on the intracranial aneurysms is good.The postoperative treatments including hypertension,high perfusion and high blood volume are helpful to preventing cerebrovascular spasm and improving the prognosis in the patients with intracranial aneurysms.

关 键 词：动脉瘤 显微手术 脑血管痉挛 疗效 

分 类 号：R743.9[医药卫生—神经病学与精神病学]