颅内动脉瘤的显微外科手术技巧（附598例报告）  

Experiences on the microsurgical operation of intracranial aneurysms （ report of 598 cases ）

作　　者：刘荣耀[1] 许瑞雪[1] 吴忠魁 姜远峰 聂晨 陈卫东[1] 张健[1] 廉治刚[1] 白景阳[1] 吴春明[1] 董斌[1] 位振清[1] 王健[1] 许友松[1] 张波[1] 李涛[1] 

机构地区：[1]大连医科大学第一附属医院神经外科,116011 [2]辽宁省瓦房店市第三人民医院神经外科

出　　处：《中华神经外科杂志》2011年第10期1045-1048,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨颅内动脉瘤的手术策略、技巧以及疗效等。方法采用夹闭、孤立、包裹等方法手术处理598例共753个动脉瘤。责任动脉瘤598例中有589例采用夹闭方法，孤立2例，包裹7例。结果出院时按GOS标准评分，良好（GOS4～5分）568例，一般（GOS3分）15例，植物生存（GOS2分）4例，11例术后死亡（GOS1分）。395例得以随访，恢复良好374例（94．7％），中残或重残18例，死亡3例。结论手术夹闭是治疗颅内动脉瘤确实有效的方法。对于复杂性颅内动脉瘤，术者需对动脉瘤有充分的认识，相应的手术技巧，方能达到满意的手术效果。Objective To study the surgical strategy, techniques, and curative effect in patients with intracranial aneurysms. Method Seven hundred and fifty - three aneurysms were treated by clipping, isolating and wrapping in598 patients. Among 598 aneurysms, 589 were treated by clipping,2 were treated by isolated and 7 were wrapped by coating. Results According to GOS standard, the outcome in the early stage was good in 568 cases （ GOS 4 - 5 points）, general in 15 cases （3 points）, plant man in 4 case （ GOS 2 points） and 11 died （ GOS 1 point）. Long - term follow - up was performed in 395 patients, 374 were recovered well, 18 moderately or severely disabled, and 3 died. Conclusions Surgical clipping was the most effective method to treat intracranial aneurysms. The measures to heighten curative effect of surgery on the complex aneurysms include sufficient recognition of the aneurysms, surgical techniques.

关 键 词：颅内动脉瘤 显微外科手术 手术技巧 

分 类 号：R651.1[医药卫生—外科学]