神经内镜辅助颅内动脉瘤夹闭术临床分析

目的探讨神经内镜辅助下夹闭术对颅内动脉瘤的治疗作用,并分析影响疗效的相关因素。方法2005年1月～2009年1月,入选患者72例,共颅内动脉瘤73个,在我科行神经内镜辅助下夹闭术,观察围手术期术后动脉瘤夹闭情况及并发症的产生情况,分析影响疗效的因素,观察出院后随访半年内再出血发生的情况。结果本组成功夹闭动脉瘤65个,8个瘤壁加固包裹术。无术中及围手术期死亡。术后出现动眼神经麻痹、肢体偏瘫、脑积水、意识障碍等并发症共11例（15.3%）。而术前Hunt-Hess分级和动脉瘤破裂情况是影响疗效的独立危险因素。随访半年,无1例有再出血发生。结论神经内镜辅助颅内动脉瘤夹闭术解剖清楚,夹闭确切,临床疗效满意;术前Hunt-Hess分级和动脉瘤破裂情况是影响疗效的重要因素。

Clinical analysis of endoscope-assisted microneurosurgery for clipping of cerebral aneurysms

Objective ] To investigate the effect of Endoscope-assisted Microneurosurgery for clipping of cerebral aneurysm, and find out the relevant factors impacting of clinical effect. Methods] 72 patients, a total of 73 cerebral aneurysms were enrolled in between January 2005 to January 2009. Endoscope-assisted Microneurosurgery for clipping of cerebral aneurysm was used. Complications and clinical effect were observed, and to analyze the factors that affect the efficacy. Six months follow-up was carried out for detecting aneurysm rebleeding. Results ] 65 aneurysms clipped aneurysms successed, 8 aneurysms accepted tumor wall reinforcement package. No intraoperative and perioperative mortality. 11 patients （15.3%） had complications, such as oculomotor nerve palsy, limb paralysis, hydrocephalus, and awareness of barriers. The preoperative Hunt-Hess grade and aneurysm rupture were independent risk factor impacting the efficacy, no rebleeding occurred in six months follow-up. Conclusion ] Endoscope-assisted Microneurosurgery gives clear anatomy, operator can clip cerebral aneurysm precisely; Preoperative Hunt-Hess grade and aneurysm rupture is an important factor impacting of efficacy.