显微镜下经翼点入路手术治疗前循环动脉瘤临床分析.docVIP

显微镜下经翼点入路手术治疗前循环动脉瘤临床分析 　　【摘要】 目的：通过分析前循环动脉瘤的显微手术治疗，探讨手术入路与技巧、避免术中动脉瘤破裂及破裂后处理以及脑血管痉挛的预防和处理。方法：回顾分析2011年3月-2015年6月笔者所在科室收治的48例前循环动脉瘤的显微手术治疗患者的临床资料。结果：手术成功率为100%，大面积脑梗死3例，基底节小面积梗死1例，单肢瘫2例，动眼神经麻痹1例，死亡2例。术后随诊2～12个月，术后恢复良好39例，轻残6例，重残2例，死亡2例。本组近期疗效良好率81.25%（39/48），病死率4.16%（2/48）。结论：经翼点入路手术夹闭是治疗前循环颅内动脉瘤的有效方法，避免动脉瘤破裂和正确处理术中破裂出血，积极防治脑血管痉挛是手术成功的关键。 中国论文网 /6/view-7251050.htm 　　【关键词】 前循环动脉瘤； 经翼点入路； 显微外科手术 　　中图分类号 R651.1 文献标识码 B 文章编号 1674-6805（2016）4-0013-03 　　Clinical Analysis of Under the Microscope Via Pterional Approach in Surgical Treatment of Anterior Circulation Aneurysms/GAO Yong-feng，ZHU Jun-wu，YAO Jun-heng，et al.//Chinese and Foreign Medical Research，2016，14（4）：13-15 　　【Abstract】 Objective：Through the analysis of anterior circulation aneurysms microsurgical treatment，to explore the surgical approach and skills， to avoid intraoperative aneurysm rupture and rupture postprocessing and cerebral vasospasm prevention and treatment.Method：The clinical data of 48 cases of anterior circulation aneurysms treated by microsurgery in our department from March 2011 to June 2015 were analyzed retrospectively.Result：The operation success rate was 100%，3 cases of large area cerebral infarction， 1 case of basal ganglia infarction area was small， single limb paralysis in 2 cases， 1 case of oculomotor nerve palsy， death 2 cases.After operation with follow-up of 2 to 12 months， the postoperative recovery good in 39 cases， mild disability in 6 cases， 2 cases of severe disability， death 2 cases. The short-term efficacy of this group was 81.25%（39/48）， the mortality rate was 4.16%（2/48）.Conclusion：The pterional approach clamp close before treatment circulation intracranial aneurysms of reliable and effective method， avoid aneurysm rupture and proper treatment of intraoperative bleeding， active prevention and treatment of cerebral vasospasm is key to the success of the operation. 　　【Key words】 Anterior circulation aneurysm； Pterional approach； Microsurgical operation 　　First-authors addr