朝向不同的后交通动脉瘤显微手术操作技巧  

Microsurgical techniques of posterior communicating aneurysms toward different orientations

作　　者：黄生炫 陈智勇 康泽辉 朱锋 Huang Shengxuan;Chen Zhiyong;Kang Zehui;Zhu Feng(Department of Neurosurgery,Affiliated Sanming First Hospital,Fujian Medical University,Sanming,Fujian 365000,China)

机构地区：[1]福建医科大学附属三明第一医院神经外科

出　　处：《中国微侵袭神经外科杂志》2019年第12期543-546,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：三明市科技计划项目[编号：2016-S-2(6)]

摘　　要：目的探讨朝向不同的后交通动脉瘤显微手术治疗。方法回顾性分析34例采用翼点入路显微手术治疗后交通动脉瘤病人的临床资料,其中瘤顶朝向后外侧下方30例,朝向后外侧上方2例,朝向后内侧下方2例。结果术后0.5~1个月常规行CTA检查,动脉瘤完全夹闭33例,瘤颈残留1例。病人术前症状均不同程度好转,留有肢体偏瘫2例,不同程度眼裂增宽及瞳孔改变10例。出院时GOS评分:5分27例,4分5例,3分2例。28例获随访3~24个月,动脉瘤残留1例,余无复发。结论术前行320排头颅CTA充分评估动脉瘤的朝向,术中合理运用手术技术,有利于手术安全,减少术后并发症。Objective To investigate the microsurgical treatment of posterior communicating aneurysm toward different orientations.Methods Clinical data of 34 patients with posterior communicating aneurysm undergoing microsurgery via pterional approach were analyzed retrospectively, including tip of the aneurysm toward infra-posterolateral orientation in 30 patients, toward upper-posterolateral in 2 and infra-posteromedial in 2. Results CTA examination was performed 0.5 to 1 month after the operation, complete aneurysm clipping was achieved in 33 patients and residual aneurysm neck in 1. The preoperative symptoms were all improved to different degree.Limb hemiplegia occurred in 2 patients, while the palpebral fissure widened to different degree and pupil changed in 10 patients. GOS scores at discharge showed 5 points in 27 patients, 4 in 5 and 3 in 2. Twenty-eight patients were followed up from 3 to 24 months,residual aneurysms occurred in 1 patient, the others had no reoccurrence. Conclusion It is beneficial to the surgical safety and can reduce the postoperative complications to fully evaluate the aneurysms orientation before the operation by 320-row CTA and reasonably apply surgical techniques.

关 键 词：颅内动脉瘤 后交通动脉 朝向 动脉瘤 夹闭术 动脉瘤 

分 类 号：R651.122[医药卫生—外科学]