破裂大脑中动脉动脉瘤的显微手术治疗  

Microsurgery for the ruptured middle cerebral artery aneurysms (report of 70 cases)

作　　者：缪洪平[1] 唐卫华[1] 陈志[1] 杨云锋[1] 牛胤[1] 朱刚[1] 林江凯[1] 冯华[1] 

机构地区：[1]第三军医大学西南医院神经外科,重庆400038

出　　处：《中国临床神经外科杂志》2011年第11期644-646,659,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨破裂大脑中动脉动脉瘤的诊断、显微手术治疗及其疗效。方法回顾性分析显微手术治疗的70例破裂大脑中动脉动脉瘤患者的临床资料。64例患者术前进行了头颅3D-CTA或/和DSA检查,6例仅行头颅CT检查。结果 70例患者中,67例行动脉瘤夹闭术,3例行动脉瘤包裹术。术后随访3月～2年,按GOS评分,5分57例,4分5例,3分5例,2分1例,1分2例;60例患者行3D-CTA或/和DSA复查,未见动脉瘤复发,其中1例行包裹术的患者动脉瘤无明显增大。结论破裂大脑中动脉动脉瘤应尽早采取显微手术治疗,以有效改善预后;术中多普勒超声的使用能为手术提供帮助。Objective To explore the method to treat the ruptured middle cerebral artery aneurysms（rMCAAs） and its curativee ffect on rMCAAs.Methods The clinical data of 70 patients with rMCAAs who underwent microsurgery in the recent 4 years werea nalyzed retrospectively.The three-dimensional CT angiography（3D-CTA） and/or DSA were performed in 64 cases and CT examinationi n 6 cases before the emergent operation.Results Of 70 rMCAAs,67 were clipped and 3 were wrapped.The following up from 3 monthst o 2 years showed that of 70 patients,57 were recovered well,5 moderately disabled,3 severely disabled,2 survived vegetatively and 2d ied according to GOS.DSA and/or 3D-CTA showed that no aneurysms recurred in 60 patients followed up during the following upp eriod.Conclusions The prognosis may be improved by microsurgery early after the rupture in the patients with rMCAAs,in whomD oppler sonography is helpful to the microsurgical operation.

关 键 词：破裂大脑中动脉动脉瘤 显微手术 疗效 

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]