锁孔入路治疗破裂的前循环动脉瘤

目的探究锁孔入路治疗破裂的前循环动脉瘤的显微技术和治疗效果。方法通过眉弓眶上和翼点锁孔入路治疗前循环动脉瘤36例,包括前交通动脉瘤13例,后交通动脉瘤16例,大脑中动脉分叉处动脉瘤7例。手术均为发病后1～3d进行。结果术中动脉瘤显露良好,36例均成功夹闭,其中2例动脉瘤术中破裂出血。29例恢复良好,6例轻残,1例死亡。结论锁孔入路可显著减小手术损伤及手术并发症。完善的术前准备和设计,熟练的手术操作技术,良好的术中配合是手术成功的保证。

Early Treatment of Acutely Ruptured Aneurysms of Anterior Circulations by Microsurgery Through Keyhole Approach

Objective To study therapeutic effect of microsurgery through keyhole approach on acutely ruptured aneurysms of anterior circulation and its techniques. Methods Thirty-six patients with aneurysms of anterior circulations, of whom, 13 suffered from anterior communicating artery aneurysms, 16 posterior communicating artery aneurysms and 7 middle cerebral artery aneurysms, were treated by mircrosurgery through supraorbital and pterional keyhole approaches, from 1 to 3 days after the rupture of the aneurysms. Results The aneurysms were exposed well during the operation. The parent artery were temporary blocked in 8 cases and aneurysm ruptured in 2 cases during the operation. All the aneurrysms were clipped. Of 36 patients with acutely ruptured aueurysms, 29 recovered well, 6 were mildly disabled and 1 died. Conclusion The early treatment of acutely ruptured-aueurysms by microsurgery through keyhole approach can reduce the operative injury and complication. The prefect preoperation preparation, individualized therapy plan, good surgical technique and operation concordance are key factors of successful operation.