翼点微骨孔入路治疗颅内前循环动脉瘤  

Treatment of anterior circulation intracranial aneurysms with a pterional keyhole approach

作　　者：王硕[1] 赵继宗[1] 隋大立[1] 王嵘[1] 齐巍[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100050

出　　处：《中国微侵袭神经外科杂志》2002年第4期193-194,共2页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨应用微骨孔入路治疗颅内前循环动脉瘤的临床效果。方法2000年11月～2001年12月采用翼点微骨孔入路治疗前循环动脉瘤病人83例,共86个动脉瘤。其中颈内动脉眼段动脉瘤3例,颈内动脉C2段动脉瘤40例,颈内动脉分叉部动脉瘤4例,前交通动脉瘤19例,前动脉水平段动脉瘤2例,中动脉水平段5例,中动脉分叉部动脉瘤13例。结果成功治疗前循环动脉瘤病人83例,共夹闭86个动脉瘤。术后出现肢体活动障碍4例,占4.8%;无手术死亡。术后80例复查脑血管造影,显示动脉瘤消失。无与开颅入路相关的并发症。本组均未输异体血液,术中采用自体血回收后输血26例。结论翼点微骨孔入路夹闭颅内前循环动脉瘤,可以降低手术中的医源性损伤并获得满意的手术效果。Objective To evaluate the results and significance of a pterional keyhole approach to intracranial aneurysm surgery of the anterior circulation.Method From November2000to December2001,83patients with86intracranial aneurysms in the anterior circulation were operated upon using this approach.Of the86aneurysms,40located on the C2segment,19on the anterior communicating artery,13at the bifurcation of the middle cerebral artery,5on the horizontal segment of the middle cerebral artery,4at the bifurcation of the internal carotid artery,3on the ophthalmic artery,and2on the horizontal segment of the anterior cerebral artery.Result All of the86aneurysms were clipped successfully without operative mortality.Only4patients(4.8%)suffered postoperative permanent motor dysfunction.Obliteration of the aneurysms was confirmed by follow-up angiography in80patients.There was no complications related to the keyhole approach.Conclusion This keyhole approach for intracranial aneurysm surgery in the anterior circulation could achieve excellent surgical results and decrease unnecessary intraoperative injury of the normal brain tissue and vessels.

关 键 词：翼点微骨孔入路 颅内前循环动脉瘤 显微手术 颅内肿瘤 手术方式 手术入路 

分 类 号：R739.41[医药卫生—肿瘤]