显微手术治疗脑动脉瘤69例报告  

Report of 69 cases cerebral aneurysm microsurgery

作　　者：赵富文[1] 程序曲[1] 支文勇[1] 

机构地区：[1]常熟市第二人民医院神经外科,江苏常熟215500

出　　处：《中国实用神经疾病杂志》2017年第23期50-53,共4页Chinese Journal of Practical Nervous Diseases

基　　金：江苏省卫生计生委科研项目;编号:YG2101504

摘　　要：目的总结近10a显微手术的脑动脉瘤病例,以明确手术适应证,并熟练掌握显微外科技术。方法确诊并开颅显微手术治疗的69例病例,分析其发病年龄、性别、临床表现、影像资料、术前诊断、手术时机、手术方法及术后处理等临床资料,总结其中经验及教训。结果随着病例的积累,患者手术病死率降低,手术良好率逐年上升。结论熟练运用显微神经外科技术及熟悉脑血管的显微解剖是手术的基础,手术的关键在于恰当地夹闭动脉瘤颈的同时控制载瘤动脉。脑脊液引流等术后治疗可使手术取得良好的疗效。Objective Analyze and summarize 69 cases of cerebral aneurysm microsurgery in recent 10 years, to provide rea- sonable surgical indications, to master microsurgical technique and be familiar with cerebral local microdissection structure, and to realize the proper postoperative treatment. Methods Collected 69 cases of cerebral aneurysm microsurgery in our hospital in recent 10 years, then analyzed the onset age, gender, clinical manifestations, imaging data, preoperative diagnosis, operation time, surgical methods and postoperative treatment. Results The mortality rate of patients was decreased and the operation rate increased year by year with the accumulation of cases. Conclusion Skilled use of microsurgery and familiar microanatomy of brain vessels are the basis of surgery. The key to the operation is to properly clamp the neck of the aneurysm while controlling the tumor artery. Post- operative treatment such as cerebrospinal fluid drainage can help to achieve good results.

关 键 词：脑动脉瘤 显微手术 脑脊液引流 脑血管痉挛 脑积水 病死率 

分 类 号：R739.41[医药卫生—肿瘤]