经翼点入路显微手术治疗破裂前交通动脉瘤  

Microsurgical treatment with ruptured aneurysms of anterior communicating artery through pterional approach

作　　者：黄永旺[1] 范学政[1] 唐景峰[1] 杜贻庆[1] 杨保华[1] 郑华平[1] 

机构地区：[1]桂林医学院附属医院神经外科,广西桂林541001

出　　处：《现代仪器与医疗》2014年第4期4-7,11,共5页Modern Instruments & Medical Treatment

基　　金：桂林市科学研究与技术开发计划课题;基金编号:桂科攻1302065

摘　　要：目的:总结经翼点入路显微外科手术夹闭破裂前交通动脉瘤的临床经验。方法:回顾性分析我院2008年7月-2013年7月行经翼点入路显微手术治疗的53例破裂前交通动脉瘤患者的影像学资料、诊疗经过、并发症、预后等。结果:早期手术(3d内)10例,中期手术(4-14d)31例,延期手术(大于14d)12例。手术效果按GOS评定(出院时),恢复良好36例(67.9%),中残7例(13.2%)重残6例(11.3%)死亡4例(7.5%)。结论:经翼点入路显微手术治疗前交通动脉瘤疗效确切,术前充分准备及正确评估,选择正确手术时机,术中对颅内压控制、对动脉瘤破裂出血正确处理、娴熟的显微手术技术以及熟练掌握局部显微解剖是保证手术成功的关键。Objective：To summarize the clinical experience of microscopic surgical treatment in patients with anterior communicating artery aneurysm.Methods：The clinical data of 53 patients with ruptured anterior communicating artery aneurysm, admitted to our hospital from July 2008 to July 2013 and performed microneurosurgical treatment via pterional approch, were retrospective analyzed;their clinical and imaging data, treatment,complications and efifcacy were concluded.Results：10 patients received early operation,31 patients received middle operation, 12 patients were delayed. Operation effect was evaluated by GOS （discharge）, 36 （67.9%）patients were discharged in good condition,7（13.2%） patients suffered from moderate disability,6（11.3%） from severe disability and 4 （7.5%）died.Conclusion：The treatment of ruptured anterior communicating artery aneurysms treated with microsurgery via pterional approach is accurate, the key to guarantee the successful operation is sufifcient preoperative preparation and correct evaluation, choosing the right operation time, intraoperative on intracranial pressure control、correctly treatment to the bleeding rupture of aneurysm、skilled microsurgery technology and mastering the local anatomy.

关 键 词：前交通动脉瘤 显微手术 翼点入路 破裂 

分 类 号：R739.41[医药卫生—肿瘤]