“锁眼”入路显微手术治疗颅内动脉瘤  

Treatment of intracranial aneurysms with keyhole approach microsurgery

作　　者：兰青[1] 张全斌[1] 黄强[1] 沈利明[2] 

机构地区：[1]苏州大学附属第二医院神经外科,江苏苏州215004 [2]苏州大学附属第二医院影像科,江苏苏州215004

出　　处：《中华神经外科疾病研究杂志》2002年第4期304-307,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：江苏省重点医学人才基金资助项目

摘　　要：目的 改进颅内动脉瘤手术入路,以最小的创伤来取得动脉瘤显微手术的最佳疗效。方法 根据颅内动脉瘤所在位置,精确设计“锁眼”手术入路,以2 cm左右直径的骨窗进行颅内动脉瘤夹闭等手术。32例手术中,眶上额下经眉弓入路28例,翼点入路1例,乳突后入路2例,额部中线旁入路1例。结果 32例患者35个动脉瘤,行32次“锁眼”显微手术,共有33个动脉瘤行夹闭术,其中3例为多发性动脉瘤,予一次手术夹闭,另行动脉瘤孤立术、包裹术各1例。所有手术无术后感染、出血及脑脊液漏等手术并发症。结论“锁眼”手术创伤小,疗效佳,外观影响少,费用节省,是动脉瘤有效和理想的显微手术入路。Objective To improve the approach for treatment of intracranial aneurysms and achieve the best results with minimal invasion during microsurgery. Methods According to the position of aneurysm , keyhole approach was designed precisely for microsurgery and the bone window was about 2 cm in diameter. Among 32 operations, supraorbital eyebrow keyhole approach was used in 28 and retromastoid keyhole approach in 2, unifrontal interhemispheric keyhole approach in 1, pterional keyhole approach in 1. Results There were 32 patients with 35 aneurysms. After these 32 operations by keyhole approach, 33 aneurysms were clipped, one aneurysm trapped and the rest one wrapped. Three patients with two aneurysms were also treated through one keyhole. There were no infection, bleeding or cerebrospinal fluid leakage after operations. Conclusion Keyhole approach microsurgery is an effective and ideal therapeutic method for intracranial aneurysm with its minimal invasion, good result and economic expense.

关 键 词：治疗 颅内动脉瘤 显微外科 微骨孔入路 

分 类 号：R739.41[医药卫生—肿瘤] R730[医药卫生—临床医学]