大脑中动脉分叉处动脉瘤的显微外科手术

发布时间：2018-03-13 13:13

本文选题：颅内动脉瘤　切入点：大脑中动脉　出处：《重庆医科大学学报》2015年01期 　论文类型：期刊论文

【摘要】：目的:总结显微外科手术夹闭大脑中动脉分叉处动脉瘤的临床经验和体会。方法:回顾性分析28例经显微外科手术治疗的大脑中动脉分叉处动脉瘤患者的临床资料、手术过程,总结经验。结果:28例患者共30个动脉瘤,其中5例伴有脑内血肿;根据计算机断层血管造影(computed tomography angiography,CTA)或数字减影血管造影(digital subtraction angiography,DSA)评估动脉瘤的大小、形态、朝向和与分叉血管的关系,精心设计显微手术;术后随访6~12月,格拉斯哥预后分级(Glasgow outcome scale,GOS)评分优良22例,中残4例,重残1例,植物生存状态1例。结论:对于大脑中动脉分叉处动脉瘤,应及早手术,术前影像学上的准确分析与评估、合适的手术入路、娴熟的手术技巧是有效夹闭大脑中动脉分叉处动脉瘤,提高术后疗效的关键。
[Abstract]:Objective: to summarize the clinical experience and experience in microsurgical clipping of aneurysms at the middle cerebral artery bifurcation. Methods: the clinical data and surgical process of 28 patients with microsurgical treatment of aneurysms at the middle cerebral artery bifurcation were analyzed retrospectively. Results there were 30 aneurysms in 28 patients, 5 of which were accompanied by intracerebral hematoma. The size and morphology of aneurysms were evaluated according to computed tomography angiography or digital subtraction angiography. The relationship between orientation and bifurcation vessels was carefully designed for microsurgery, Glasgow outcome scale score was excellent in 22 cases, moderate disability in 4 cases, severe disability in 1 case, and follow-up from 6 to December, Glasgow outcome scale scale score was good in 22 cases, 4 cases with moderate disability and 1 case with severe disability. Conclusion: for aneurysms of middle cerebral artery bifurcation, early operation, accurate analysis and evaluation of preoperative imaging, and appropriate approach should be made. Skillful surgical techniques are the key to the effective clipping of aneurysms at the middle cerebral artery bifurcation and the improvement of postoperative efficacy.
【作者单位】：重庆医科大学附属第二医院神经外科;
【分类号】：R651.12

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