前交通动脉瘤破裂早期显微手术治疗

【目的】探讨前交通破裂动脉瘤破裂早期显微手术治的疗效。【方法】对本院50例前交通动脉瘤破裂出血患者在48 h内经翼点入路行显微手术治疗，探讨其影像学特点、手术方法。【结果】50例前交通动脉瘤术中诊断与术前一致，其中多发动脉瘤5例，合并后交通动脉瘤3例，大脑中动脉瘤1例，位于同侧，1次手术夹闭。合并双侧颈内动脉C2段动脉瘤1例，一次夹闭主侧两动脉瘤，位于对侧C2段动脉瘤，继续观察。出血动脉瘤均为中小型动脉瘤。术后6个月GOS分级Ⅴ级43例，Ⅳ级2例，Ⅲ级1例，Ⅱ级2例，Ⅰ级2例。【结论】前交通破裂动脉瘤显微手术治疗，注意细节，个体化处理是成功治疗的关键，早期显微手术清除积血，夹闭动脉瘤，效果满意。

Early Microsurgery for the Treatment of Ruptured Aneurysms of Anterior Communicating Ar-tery

Objective]To explore the efficacy of early microsurgical treatment of ruptured aneurysms of anterior communicating （ACOM ） artery .Methods] Totally 50 patients with ruptured aneurysms of ACOM artery in our hospital underwent microsurgery through the pterional approach within 48 hours .The imaging characteristics and operation methods were discussed .Results]The intraoperative diagnosis was consistent with preoperative diagnosis in 50 patients .Among them ,5 patients were multiple aneurysms ,and 3 patients were posterior communicating artery aneurysm ,and 1 patient was middle cerebral artery aneurysm ,which was ipsilateral and occluded by operation for one time ,and 1 patient was C2 segment aneurysm of bilateral carotid artery in which two aneurysms of major lateral carotid artery were occluded by operation for one time and con-tralateral C2 segment aneurysms were observed continuously .The ruptured aneurysms were middle and small aneurysms .After the operation for 6 months ,43 patients were Glasgow outcome scale（GOS） grade Ⅴ ,and 2 patients were grade Ⅳ ,and 1 patient was grade Ⅲ ,and 2 patients were grade Ⅱ ,and 2 patients were gradeⅠ .Conclusion] Attention to the details and individual management are the critical for the success microsur-gery of ruptured aneurysms of ACOM artery .Early microsurgery for clearing hematocele and occluding aneu-rysms can achieve the satisfactory results .