经翼点入路显微手术治疗破裂前交通动脉瘤.pdfVIP

论 著 2014年  第20卷   第4期 经翼点入路显微手术治疗破裂前交通动脉瘤 黄永旺　范学政　唐景峰　杜贻庆　杨保华　郑华平 （桂林医学院附属医院神经外科，广西桂林　541001 ） [摘　要]　目的：总结经翼点入路显微外科手术夹闭破裂前交通动脉瘤的临床经验。方法：回 顾性分析我院2008 年7 月-2013 年7 月行经翼点入路显微手术治疗的53 例破裂前交通动脉瘤 患者的影像学资料、诊疗经过、并发症、预后等。结果：早期手术（3d 内）10 例，中期手术 （4-14d ）31 例，延期手术( 大于14d ）12 例。手术效果按GOS 评定( 出院时) ，恢复良好36 例 （67.9% ），中残7 例（13.2% ）重残6 例（11.3% ）死亡4 例（7.5% ）。结论：经翼点入路显微手 术治疗前交通动脉瘤疗效确切，术前充分准备及正确评估，选择正确手术时机，术中对颅内压 控制、对动脉瘤破裂出血正确处理、娴熟的显微手术技术以及熟练掌握局部显微解剖是保证手 术成功的关键。 [关键词]　前交通动脉瘤；显微手术；翼点入路；破裂 中图分类号：R739.41　文献标识码：A　文章编号：2095-5200（2014）04-004-04 DOI：10.11876/mimt201404002 Microsurgical treatment with ruptured aneurysms of anterior communicating artery through pterional approach HUANG Yong-wang FAN Xue-zheng TANG Jing-feng ， ， ， DU Yi-qing YANG Bao-hua ZHENG Hua-ping. Department of neurosurgery of the ， ， （ Affiliated Hospital of Guilin Medical University Guilin 541001 China ，Guangxi ， ） [Abstract]　Objective ：To summarize the clinical experience of microscopic surgical treatment in patients with anterior communicating artery aneurysm. Methods ：The clinical data of 53 patients with ruptured anterior communicating artery aneurysm, admitted to our hospital from July 2008 to July 2013 and performed microneurosurgical treatment via pterional approch, were retrospective analyzed; their clinical and imaging data, treatment,complications and efficacy were concluded. Results ：10 patients received early operation,31 patients received middle operation, 12 patients were delayed. Operation effect was evaluated by GOS (discharge), 36 (67.9%)patients were discharged in good condition，7(13.2%) patients suffered from moderate disability，6(11.3%) from severe disability and 4 (7.5%)died ．Conclusion ：The treatmen