显微外科夹闭颅内前循环动脉瘤120例报告

目的探讨早期显微外科手术对颅内动脉瘤的治疗效果。方法回顾性分析手术治疗120例颅内前循环动脉瘤的临床表现、影像学资料和手术,所有患者均采用经翼点入路或前纵裂入路。早期手术68例,中晚期手术52例。结果术前CTA能清楚显示动脉瘤的大小、形状以及载瘤动脉的特征。68例早期手术患者出院时按GOS评分恢复良好者59例,中残5例,重残2例,死亡2例;52例中晚期手术患者按GOS评分恢复良好者30例,中残14例,重残2例,死亡6例;2组治疗效果比较有显著性差异。结论早期手术夹闭动脉瘤能有效防止动脉瘤再次破裂引起的直接死亡和病情恶化;熟练的显微外科手术技巧和术中正确处理动脉瘤的方法,对提高手术成功率和预后至关重要。

Microsurgical clipping aneurysms of 120 patients with intracranial anterior communicating artery

Objective To explore the therapeutic efficacy of early microsurgical clipping intracranial aneurysms.Methods 120 patients with intracranial anterior circle aneurysms underwent microsurgery through pterional approach or anterior fissure approach.The clinical manifestations,angiograms,and surgical operation were retrospectively analyzed.68 patients were operated at early period,and 52 patients at middle and advanced stage.Results Preoperative computed tomographic angiography(CTA) could identify the size and the shape of aneurysms,as well as the character of carrying arteries.According to GOS,among the 68 cases with anterior part aneurysms that were successfully clipped,59 patients were discharged in good condition,5 patients suffered from moderate disability,2 patients in severe disability and 2 died;Among the other 52 patients,30 patients were discharged in good condition,14 patients suffered from moderate disability,2 were in severe disability and 6 died;There was a significant difference between the two groups.Conclusion Early clipping of aneurysms can effectively prevent death and deterioration of condition caused by aneurismal re-rupture.The surgeon should master proficient microsurgical techniques and correct intraoperative treatment on aneurysms,it is critical to elvate the operation achievement ratio and the prognosis.