显微手术治疗前交通动脉瘤破裂23例临床分析

目的：：探讨前交通动脉瘤破裂显微神经外科治疗的临床效果。方法：回顾分析前交通动脉瘤破裂患者23例临床资料,其中16例采用 Yasargil 翼点入路,7例采用眶上锁孔入路。结果：手术效果按格拉斯哥预后评分,恢复良好18例(78.3%),中残1例(4.3%),重残2例(8.7%),死亡2例(8.7%)。随访时间6~12个月,术后复查 CT 动脉血管成像未见夹闭不全或误夹血管。结论：对 Hunt-Hess 分级Ⅰ~Ⅲ级前交通动脉瘤破裂患者进行显微手术治疗,翼点入路及眶上锁孔入路术中均能清楚暴露瘤颈,是较佳的治疗方法。

The clinical analysis of microsurgery in the treatment of ruptured anterior communicated artery aneurysm in 23 cases

Objective: To investigate the clinical effects of microsurgery in treating the rupturing anterior communicating artery aneurysm. Methods:The clinical data of 23 cases with rupturing anterior communicating artery aneurysm were retrospectively analyzed. Sixteen cases were treated with Yasargil pterional approach,7 cases were treated with supraorbital keyhole approach. Results:According to the Glasgow Outcome Score,18 patients(78. 3% ) were complete recovery,1 case(4. 3% ) was moderate disability,2 cases(8. 7% ) were severe disability and 2 cases(8. 7% ) died. All patients were followed up for 6 to 12 months. No incomplete or false clipping vessel were observed by the postoperative CTA. Conclusions:The pterional approach and supraorbital keyhole approach,which can fully expose the aneurysms,is an effective method in treating anterior communicating artery aneurysms in the patients with grade Ⅰto Ⅲ of Hunt-Hess rupture.