前交通动脉瘤的显微手术治疗

目的介绍翼点入路治疗前交通动脉瘤的手术经验，提高手术疗效。方法回顾性分析56例前交通动脉瘤病人的临床表现、影像资料、手术治疗及预后情况。56例均行直接夹闭术，1例加做包裹术。结果治愈或良好47例，致残8例，死亡1例。随访5个月～3年，无动脉瘤再出血发生。结论翼点入路手术治疗前交通动脉瘤显露充分、术式成熟、并发症少，配合多种外科技术如临时阻断的应用、脑保护、控制性低血压等，可收到满意的手术疗效。

Microsurgical treatment of anterior communicating artery aneurysm

Objective To introduce the operative experience of the pterional approach for treating anterior communicating artery(ACoA) aneurysm so as to improve operative outcomes. Methods A retrospective analysis had been made in 56 patients with ACoA aneurysms in respect of the clinical manifestations, imaging findings, surgical therapy and prognosis. Results All 56 cases underwent direct clipping operation, 1 wrapped in addition. At the time of leaving hospital, as a result, 47 cases get well recovered, 8 disabled and 1 died. During the follow-up of 5 months to 3 years, no aneurysm hemorrhage was found again. Conclusion Pterional approach for treating ACoA aneurysm is an effective method with the advantages of full exposure, rare complications and well-developed operative techniques. Moreover, the additional application of multiple surgical techniques such as temporary occlusion of parent arteries, brain protection, controlled hypotension and shrinkage of aneurismal neck will contribute to a better therapeutic outcomes.