颅内外高流量分流联合颈内动脉结扎术治疗的巨大症状性颈内动脉海绵窦段动脉瘤  

Clinical efficacy of high-flow extracranial-intracranial bypass combined with internal carotid artery ligation for giant symptomatic cavernous carotid artery aneurysms:report of 4 cases and literature review

作　　者：张文华 李亚雄 李岩 陈凌友 井山泉[1] 纪乐 刘建峰[1] 李聪慧 ZHANG Wen-hua;LI Ya-xiong;LI Yan;CHEN Ling-you;JING Shan-quan;JI Le;LIU Jian-feng;LI Cong-hui(Department of Neurosurgery,The First Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第一医院神经外科,石家庄050000

出　　处：《中国临床神经外科杂志》2022年第1期13-15,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨颅内外高流量分流联合颈内动脉结扎术治疗巨大症状性颈内动脉海绵窦段动脉瘤的临床疗效。方法回顾性分析2015年5月至2020年5月运用颅内外高流量分流联合颈内动脉结扎术治疗的4例颈内动脉海绵窦段巨大动脉瘤的临床资料。结果术后症状明显改善。出院后随访1~4年,4例GOS评分均为5分。术后1年复查颅脑CT和CTA显示巨大动脉瘤完全消失3例,动脉瘤明显变小伴瘤内血栓形成1例。结论颅内外高流量分流术联合颈内动脉结扎术是治疗巨大症状性海绵窦段动脉瘤的有效方法,尤其是缓慢结扎颈内动脉的方法是安全可靠的。Objective To investigate the clinical efficacy of high-flow extracranial-intracranial(EC-IC)bypass combined with internal carotid artery(ICA)ligation for the giant symptomatic cavernous carotid artery aneurysms(CCAA).Methods The clinical data of 4 patients with giant symptomatic CCAA who underwent high-flow EC-IC bypass combined with ICA ligation from May 2015 to May 2020 were retrospectively analyzed.The related literatures were reviewed.Results The symptoms were significantly improved in all the patients after the surgery.Re-examination of CT and CTA 1 year after the operation showed that the giant aneurysms were disappeared completely in 3 patients and the aneurysm were shrunk significantly with thrombosis in aneurysm sac of 1 patient.The follow up(1~4 years)showed GOS score of 5 in all the patients.Conclusions High-flow EC-IC bypass combined with ICA ligation is an effective treatment for the patients with giant symptomatic CCAA.The ligation of the ICA is safe and reliable.

关 键 词：颅内巨大动脉瘤 颈内动脉海绵窦段 颅内外高流量分流术 颈内动脉结扎术 

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]